Exploration of genetic counselling service provision to rural patients using Telehealth at a single tertiary centre
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Date
2020-07-09
Authors
Bonnell, Emily Vie
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Abstract
A traditional genetics consultation is delivered face-to-face in a hospital setting. The majority of genetics clinics are located in urban centres making it difficult for approximately 20% of rural Canadians to access genetic services. To ameliorate difficulties with access, genetics clinics throughout the country have adopted Telehealth, a secure video-conferencing system, to provide genetic services to rural patients. Previous research regarding genetic Telehealth consultations focuses on patient satisfaction alone and was primarily conducted within the discipline of hereditary cancer. The following study argues that Telehealth increases a rural patient’s access to quality genetic services.
This study used a mixed methods approach to characterize Telehealth usage trends and explore the outcomes and experiences of a genetic patient accessing services via Telehealth at Shared health’s Genetics and Metabolism Program in Winnipeg. Prong 1 analyzed Telehealth usage data at the genetics clinic to determine trends over time. Prong 2 utilized the “Genetic Counselling Outcome Scale” (GCOS), a measure of empowerment, to determine if patient-reported outcomes of a Telehealth consultation are comparable to an in-person consultation. Prong 3 used semi-structured interviews with Telehealth patients across various genetic disciplines to explore their attitudes and experiences which are deeper than overall satisfaction.
The results of this study indicate that the number of Telehealth consultations increased consistently over the 16-year study period, with consultations for a variety of indications in all genetic disciplines. In-person and Telehealth GCOS scores were very similar, suggesting that genetics consultations through Telehealth achieve a comparable level of patient reported empowerment to in-person consultations. Semi-structured interviews uncovered the experiences of a rural patient accessing healthcare and how Telehealth helped meet a healthcare need for most individuals. The majority of participants identified many advantages, such as time and cost savings and few limitations to genetic Telehealth appointments. Furthermore, participants discussed decision-making and various coping mechanisms used throughout the genetic testing process which are similar to the experience of many genetics patients. Finally, participants shared the actions and personality traits of their genetic healthcare providers (GHPs) exemplifying that their skills and abilities translate through the Telehealth modality.
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Keywords
Telehealth, Genetic counselling, Video-conferencing, Healthcare