Test of an online tool to facilitate NCCN guideline-compliant access to cancer genetics care

• Published in: Journal of clinical oncology Vol. 38; no. 15_suppl; p. 1542
• Main Authors: Milliron, Kara J., Cook, Amanda, Keren, David, McCain, Lynn A., Schroeder, Lee, Hulswit, Bailey, Arthurs, James, Harper, Diane M, Ernst, Susan, Zazove, Philip, Parvaz, Jasmine, Merajver, Sofia
• Format: Journal Article
• Language: English
• Published: 20.05.2020
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2020.38.15_suppl.1542

Abstract only 1542 Background: Minority populations experience inequities of access to cancer genetics. We developed and tested an online family history collection and interpretation tool, InheRET, to determine acceptability, validity and utility.Patients are mostly unable to recall accurate family history in clinic and providers have little time to collect the 3-generation pedigree. Thus, ~90% of high risk patients remain unidentified. We evaluated the impact InheRET has on facilitating National Comprehensive Cancer Network (NCCN) Guideline-compliant referrals for cancer genetic counseling. Methods: Patients from 3 clinics were consented online to participate. A user experience survey for patients and providers followed the health history questionnaire. Results: 628 patients were consented over a year, 555 (>88%) completed the tool. 439 (79%) completed the post-questionnaire user experience. Review of Inheret's recommendations by a genetic counselor found 100% accuracy. Ease of Use: 84-87% of patients reported tool was easy to use. Understandability: 92-97% of patients reported tool was easy to understand. No significant differences were reported between those with high school (n=28, avg age 50.1 yrs) compared to those with advanced degrees (n=139, avg age 45.4 yrs); patients age 70+ experienced increased difficulties. Among primary care patients (n=135), 43 established patients were newly identified as meeting NCCN referral criteria. Healthcare providers found InheRET useful, did not require extra clinical time, and all wish to continue to use it. The patient provided data were more complete and encompassed more family members than with paper forms. Turn-around-times to receive the patient’s information were decreased from 4-6 weeks to ~ 72 hours. A patient scheduling backlog of 400 patients was cleared using InheRET. Previously, 40% of cancer genetics patients were lost to follow up, due to not completing their intake forms. This number was reduced to 6.5%. Conclusions: Patients find InheRET to be easy to use and understand and they complete this health history tool more frequently and in greater detail than by paper forms. InheRET provides accurate results, verified by in person interviews, in a timely fashion, saving clinical time, possibly enabling increase in earned clinical revenues (under analysis), and improving patient care overall. Importantly, the 43 primary care patients identified to be at increased risk were already established patients, who had not been previously identified as such by their healthcare providers as being at increased risk.