Oncology Rounds

How Sharp HealthCare is improving access to genetic counseling

by Deirdre Saulet

Editor's note: This blog post was updated on February 12, 2019.

Over the past decade, the field of genetics has rapidly evolved, leading to more testing options and more people who would benefit from these tests. For providers, it is more critical—and difficult—than ever to stay on top of emerging evidence and guidelines. This increased complexity also means that organizations must make the most of valuable, and often limited, genetic counselor expertise.

How your genetic counseling program can go from 'good' to 'great'

To keep up with increasing demand and expanding evidence, Sharp HealthCare invested in CancerIQ, an online platform aimed at helping providers identify patients with genetic risk factors, streamline evaluation, and manage at-risk patients over time. 

CancerIQ helps streamline and standardize the genetic counseling process

When we spoke to Nancy Harris, VP of Oncology at Sharp, she highlighted a number of benefits Cancer IQ has brought to her genetic counseling program:

  • Maximize genetic counselors' productivity: The software allows genetic counselors to focus on value-add activities and spend less time on paperwork, risk models, test order processing, and documentation. In fact, Sharp estimates that CancerIQ has reduced the amount of genetic counselor time it takes to get patients through the entire process by 40%. As a result, the 2.0 FTE genetic counselors at Sharp saw 895 consults in 2018. And about a quarter of those referrals were for patients with a cancer diagnosis with pending surgery or treatment—a group that Sharp promises to see within two weeks of referral.

  • Ensure standardization and evidence-based care: Sharp and CancerIQ worked together to developing custom templates for patient consults, making it easier for genetic counselors to create consistent, standardized reports. They've also worked closely with the Sharp IT team to automatically file reports into the EHR. And because CancerIQ is a web-based platform, it updates in real time to incorporate NCCN guideline changes.

  • Streamline referrals: The team designed a referral form that makes it easy for Sharp physicians to identify and refer eligible patients. Private practices are able to use an editable PDF form to input necessary information and Sharp then enters the information into the CancerIQ system. In addition, referring physician satisfaction has improved as the turnaround time for appointments, follow up, and test results has decreased.

  • Gain visibility into performance: CancerIQ provides administrative reports that allow Sharp to compare its stats and performance to the rest of CancerIQ's customers. Not only does this help Sharp continue making the case for investing in this product, but it also will allow Sharp to identify ongoing opportunities for improvement.

CancerIQ helps Sharp meet growing demand for genetic counseling

After implementing CancerIQ in November of 2017, Sharp has seen patient access to genetic counseling dramatically improve.

In 2017, Sharp's two genetic counselors saw 633 consults—that number increased by over 40% in 2018, during which they saw 895 consults. Sharp was able to accommodate this increase without adding FTEs, underscoring how much productivity was gained using CancerIQ. 

Making the case to invest in genetic counseling

To help other program leaders make the business case for this type of investment, Nancy Harris shared her approach. First, approximate the time needed for genetic counselors to collect family history, calculate risk, perform initial and follow-up sessions, generate letters and documentation, and complete insurance paperwork, and the cost of those activities given the average genetic counselor's salary. Then, calculate the time savings gained through CancerIQ and resulting salary expense savings. For Sharp, the increased number of patients seen for counseling with the same number of genetic counselors is certainly a financial win.

You should also try to quantify the downstream utilization and revenue stemming from genetic counseling, including patient visits, breast MRIs, increased number and frequency of screenings, and prophylactic surgeries. From November 2017 (when they implemented CancerIQ) to the end of 2018, Sharp tracked the following care management recommendations:

Importantly, these changes have a direct impact on revenue. For example, over 150 women were recommended to receive annual breast MRI instead of the typical mammogram. According to the Advisory Board's Hospital Benchmark Generator, the median contribution profit for a hospital MRI is about $152—more than double the median contribution profit per mammogram (about $74).

Additionally, there are myriad qualitative benefits, including improved quality outcomes, reliability, standardization, long-term tracking, and adherence to evidence-based care. And, as we learned from one of our Advisory Board colleagues, genetic counseling services can help build patient loyalty and differentiate your health system in your market. 

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