BPI20-008: Pilot Testing of InheRET™, an Online Tool to Facilitate NCCN Guideline®-Compliant Referrals for Cancer Genetic Counseling and Increase Access to Care

This pilot study evaluated the impact InheRET™ has on facilitating National Comprehensive Cancer Network (NCCN) Guideline®-compliant referrals for cancer genetic evaluation by decreasing and/or removing the barriers of time-consuming, in-clinic, three-generation family history collection and interpretation. Using InheRET for hereditary cancers, patients from three diverse clinics were consented to participate, including Dexter Family Medicine, University Health Services, and Michigan Medicine Breast and Ovarian Cancer Risk Evaluation Clinic (BOCREC). Patients were invited to complete InheRET by giving them a link to www.inheret.org. Once patients completed their health history, a user experience survey immediately followed. The experience survey used a Likert scale with free-text comments. Participating providers (n=17) were also surveyed to measure time, processes, and utility. 686 patients were consented between October 1, 2018 and August 30, 2019, and 596 (87%) completed InheRET. Of these, 481 (81%) completed the experience survey. Genetic counselor review found 100% accuracy of the InheRET report referral recommendations. 87% of primary care and 82% of cancer genetics patients reported InheRET was easy to use. 92% of primary care and 96% of cancer genetics patients reported InheRET was easy to understand. Among primary care patients (n=138), 44 established patients were identified as meeting NCCN genetics referral criteria. Meanwhile, 16% (81) of outside referrals to cancer genetics were found to be unnecessary. Healthcare providers found InheRET to be useful, didn't take extra clinical time, and 100% wish to continue to use InheRET following the pilot. Genetic counselors report the data provided by the patients as more complete than previous using paper forms. In addition, turn-around-time decreased from 4-6 weeks to ∼72 hours and patient backlog of over 400 patients was completely cleared. . In conclusion, patients find InheRET easy to use and understand and will complete the questionnaire more frequently and in greater detail than in clinical settings or in paper forms. InheRET provides accurate results in a timely fashion, saves clinical time, drives clinical revenue, and improves patient care. The 44 primary care patients identified were not previously identified by their healthcare providers as being at increased risk and are now able to access genetic counseling and can take steps to reduce their cancer risk.

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Corresponding Author: Amanda M. Cook, BA