Assessment of local provider engagement of an in-home collaborative model for remote genetic services

Abstract

Purpose

Clinical genetic testing demand has increased in the era of precision medicine. However, the availability of cancer genetic services remains limited in the United States, prompting a rise in telehealth delivery. Through our Telegenetics program, we seek to promote genetic service delivery across the United States, and here, we assess engagement through registrations with local providers using a service delivery model.

Methods

This report describes the Penn Telegenetics Program experience across 4 research and clinical activities using an in-home collaborative local provider model. We report the clinical procedures and our initial experience implementing this model across these 4 research and clinical activities in the Penn Telegenetics Program. We present descriptive findings of the registrations and, in cases of refusals, the rationale provided.

Results

From 2018 to 2025, 473 providers (89.4%) successfully registered. Providers were predominantly MD/DO licensed (85.0%). Family medicine was the most frequent specialty (54.3%), followed by internal medicine (20.9%) and clinical oncology (11.8%). Most providers were in suburban locations by zip codes (56.2%); 20.1% were in rural zip codes. Only 56 providers declined collaboration (10.6%); the most common reasons reported were preferring local genetic services (22.5%) and not being comfortable as the ordering provider (22.5%).

Conclusion

Our data demonstrate that most local providers are willing to collaborate with a centralized telegenetics program. Still, subsequent engagement from local providers in follow-up questions or other referrals remains a missed opportunity to improve telegenetics access. Refining procedures to increase collaborative care and engagement may provide opportunities to increase access to cancer genetic testing.