The COVID-19 pandemic has significantly disrupted the delivery of healthcare services, including oncology. To ensure continuity of cancer genetic counseling at a large academic medical center while also promoting the safety of patients and staff, our team transitioned to fully remote telephone genetic counseling and testing services within 48 hr. We compare differences in the six weeks following the shift to telephone genetic counseling (post-COVID) to the six weeks preceding the pandemic (pre-COVID). We maintained 99% of our total visit capacity and saw a decrease in patient no-show rate from 9.5% to 7.3%. Of all patients who received telephone genetic counseling, fewer consented to genetic testing as compared to patients seen in-person prior to the pandemic (79% pre-COVID v. 72% post-COVID; p = .012). Four weeks after this cohort was closed for analysis, 96 out of 303 samples (32%) had not been received by the genetic testing laboratory, despite at least one reminder phone call to the patient. In 13 reported instances, a second sample was required (quality not sufficient, lost or mislabeled sample), thus delaying test results. We conclude that a rapid transition to remote genetic counseling and testing allowed uninterrupted access to cancer genetics services during to the COVID-19 pandemic. Patient compliance with sample return and higher rates of sample failure emerge as potential barriers to timely genetic testing under this service delivery model.

中文翻译：

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在 COVID-19 大流行期间过渡到电话遗传咨询服务

COVID-19 大流行严重扰乱了包括肿瘤学在内的医疗保健服务的提供。为了确保大型学术医疗中心癌症遗传咨询的连续性，同时也促进患者和工作人员的安全，我们的团队在 48 小时内过渡到完全远程电话遗传咨询和检测服务。我们比较了转向电话遗传咨询后六周（COVID 后）与大流行前六周（COVID 前）的差异。我们保持了总访问量的 99%，患者未出现率从 9.5% 下降到 7.3%。在接受电话遗传咨询的所有患者中，与大流行之前亲自就诊的患者相比，同意进行基因检测的患者较少（COVID 前 79% 与 COVID 后 72%；p = .012）。在该队列关闭进行分析 4 周后，尽管至少给患者打了一个提醒电话，但基因检测实验室未收到 303 份样本中的 96 份（32%）。在报告的 13 个实例中，需要第二个样本（质量不够、样本丢失或贴错标签），从而延迟了测试结果。我们得出的结论是，在 COVID-19 大流行期间，快速过渡到远程遗传咨询和检测允许不间断地获得癌症遗传学服务。在这种服务提供模式下，患者对样本返回的依从性和更高的样本失败率成为及时进行基因检测的潜在障碍。