Implementation of a genetic testing stewardship program in a pediatric hospital setting

Genetic testing and genetic counseling are crucial components of the growing Precision Medicine initiative in healthcare. It has been established that the implementation of utilization management programs that include genetic counselors in laboratory settings has contributed to improved outcomes (Mathias et al., 2016; Miller et al., 2014; Riley, Procop, Kottke-Marchant, Wyllie, & Lacbawan, 2015). This study aims to assess a novel Genetic Testing Stewardship Program (GTSP) in a clinical pediatric setting, and its financial and clinical effects. A retrospective analysis of a clinical database maintained by genetic counselors in the GTSP was performed to determine the impact and outcome of 460 consults placed for genetic testing and counseling between January 1st, 2019 and December 31st, 2019. An overall cost savings was estimated to be $470,568. The GTSP influenced testing outcomes of 187 (40.7%) cases through adjustment of test requests. They also provided additional services to consulting providers with regards to several aspects of the genetic testing process. Data regarding provider experiences with the program was collected via a survey of providers who consulted the GTSP in 2019. We analyzed responses from 46 provider surveys and determined a significant difference in comfort levels with aspects of genetic testing and counseling with and without the use of the program. These results suggest that the implementation of the GTSP resulted in measurable institutional cost savings for genetic testing and an improvement in clinical patient care as perceived by providers using the service.M.S.Includes bibliographical reference