Abstract
Telemedicine applications are increasingly being introduced in patient care in various disciplines, including clinical genetics, mainly to increase access to care and to reduce time and costs for patients and professionals. Most telegenetics reports describe applications in large geographical areas, showing positive patients’ and professionals’ satisfaction. One economic analysis published thus far reported lower costs than in-person care. We hypothesized that telegenetics can also be beneficial from the professional’s view in relatively small geographical areas. We performed a pilot study in the Northern Netherlands of 51 home-based online counseling sessions for cardiogenetic and oncogenetic cascade screening, and urgent prenatal counseling. Previously, we showed patient satisfaction, anxiety, and perceived control of online counseling to be comparable to in-person counseling. This study focuses on expectations, satisfaction, and practical evaluations of the involved counselors, and the impact in terms of time and costs. Most counselors expected disadvantages of online counseling for themselves and their patients, mainly concerning insufficient non-verbal communication; few expected advantages for themselves. Afterwards, counselors additionally raised the disadvantage of insufficient verbal communication, and reported frequent technical problems. Their overall mean telemedicine satisfaction itemscore was 3.38 before, and 2.95 afterwards, being afterwards slightly below the minimum level we set for a satisfactory result. We estimated reduced time and costs by online counseling with about 8% and 10–12%, respectively. We showed online genetic counseling to be effective, feasible and cost-efficient, but technical improvements are needed to increase counselors’ satisfaction.
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References
Flodgren G, Rachas A, Farmer AJ, Inzitari M, Shepperd S : Interactive telemedicine: effects on professional practice and health care outcomes. Cochrane database Syst Review 2015; 9: CD002098.
Silva BMC, Rodrigues JJPC, De la Torre Díez I, López-Coronado M, Saleem K : Mobile-health: a review of current state in 2015. J Biomed Inform 2015; 56: 265–272.
Mehrota A, Paone S, Martich GD, Albert SM, Shevchik GJ : Characteristics of patients who seek care via evisits instead of office visits. Telemed J E Health 2013; 19: 1–5.
Merell RC : Editorial: Telemedicine for vulnerable populations. Telemed J E Health 2014; 20: 885–886.
Stalker HJ, Wilson R, McCune H, Gonzalez J, Moffett M, Zori RT : Telegenetic medicine: improved access to services in an underserved area. J Telemed Telecare 2006; 12: 182–185.
Wade VA, Karnon J, Elshaug AG, Hiller JE : A systematic review of economic analyses of telehealth services using real time video communication. BMC Health Serv Res 2010; 10: 233.
Buchanan AH, Datta SK, Skinner CS et al: Randomized trial of telegenetics vs. in-person cancer genetic counseling: cost, patient satisfaction and attendance. J Genet Counsel 2015; 24: 961–970.
Zilliacus E, Meiser B, Lobb AE et al: Are videoconferenced consultations as effective as face-to-face consultations for hereditary breast and ovarian cancer genetic counseling? Genet Med 2011; 13: 933–941.
Meropol NJ, Daly MB, Vig HS et al: Delivery of internet-based cancer genetic counseling services to patients’ homes: a feasibility study. J Telemed Telecare 2011; 17: 36–40.
d’Agincourt-Canning L, McGillivray, Panabaker K et al: Evaluation of genetic counseling for hereditary cancer by videoconference in British Columbia. BC Med J 2008; 50: 554–559.
Elliot AM, Mhanni AA, Marles SL et al: Trends in telehealth versus on-site clinical genetics appointments in Manitoba: a comparative study. J Genet Couns 2012; 21: 337–344.
Zilliacus E, Meiser B, Lobb E, Dudding TE, Barlow-Stewart K, Tucker K : The virtual consultation: practitioners’ experiences of genetic counseling by videoconferencing in Australia. Telemed J E Health 2010; 16: 350–357.
Otten E, Birnie E, Ranchor AV, Van Langen IM : Telegenetics use in presymptomatic genetic counseling: patient evaluations on satisfaction and quality of care. Eur J Hum Genet 2015, e-pub ahead of print 15 July 2015 doi:10.1038/ejhg.2015.164.
Skirton H, Goldsmith L, Jackson L, Tibben A : Quality in genetic counseling for presymptomatic testing—clinical guidelines for practice across the range of genetic conditions. Eur J Hum Genet 2013; 21: 256–260.
Bensend TA, McCarthy Veach P, Niendorf KB : What’s the harm? Genetic counselor perceptions of adverse effects of genetic service provision by non-genetics professionals. J Genet Counsel 2014; 23: 48–63.
Yip MP, Chang AM, Chan J, Mackenzie AE : Development of the Telemedicine Satisfaction Questionnaire to evaluate patient satisfaction with telemedicine: a preliminary study. J Telemed Telecare 2003; 9: 46–50.
Hojat M, Xu G : A visitor’s guide to effect sizes: statistical significance versus practical (clinical) importance of research findings. Adv Health Sci Educ Theory Pract 2004; 9: 241–249.
Iredale R, Gray J, Murtagh G : Telegenetics: a pilot study of video-mediated genetic consultations in Wales. Int J Med Market 2002; 2: 130–135.
Zilliacus E, Meisser B, Lobb E, Barlow-Stewart K, Tucker K : A balancing act—telehealth cancer genetics and practitioners’ experiences of a triadic consultation. J Genet Couns 2009; 18: 598–605.
Whitten P, Love B : Patient and provider satisfaction with the use of telemedicine: overview and rationale for cautious enthusiasm. J Postgrad Med 2005; 51: 294–300.
Grigsby B, Brega AG, Bennett RE et al: The slow pace of interactive video telemedicine adoption: the perspective of telemedicine program administrators on physician participation. Telemed J E Health 2007; 13: 487–499.
Barton PL, Brega AG, Devore PA et al: Specialist physicians’ knowledge and beliefs about Telemedicine: a comparison between users and nonusers of the technology. Telemed J E Health 2007; 13: 487–499.
Rantanen E, Hietala M, Kristoffersson U et al: What is ideal genetic counseling? A survey of current international guidelines. Eur J Hum Genet 2008; 16: 445–452.
Yi MY, Jackson JD, Park JS, Probst JC : Understanding information technology acceptance by individual professionals: toward an integrative view. Inform Manage 2006; 43: 350–363.
Aronson SJ, Clark EH, Varugheese M, Baxter S, Babb LJ, Rehm HL : Communicating new knowledge on previously reported genetic variants. Genet Med 2012; 14: 713–719.
Hunt K : Individualizing the informed consent process for whole genome sequencing: A patient directed approach [PhD thesis]. AZ, USA: Arizona State University, 2013.
Acknowledgements
This pilot project was facilitated by grants from the Dutch ‘Innovatiefonds zorgverzekeraars’ and from the European Social Fund (Grant number 2010ESFN630). We thank the counselors, case managers, web coordinator, Theo van de Meer (De Praktijk), and Jack van Gils and the other contributors from his company myCoachconnect for their participation and support. We thank Jackie Senior for editing our manuscript.
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Otten, E., Birnie, E., Ranchor, A. et al. Online genetic counseling from the providers’ perspective: counselors’ evaluations and a time and cost analysis. Eur J Hum Genet 24, 1255–1261 (2016). https://doi.org/10.1038/ejhg.2015.283
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DOI: https://doi.org/10.1038/ejhg.2015.283
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