Introducing eHealth and other innovative options into clinical genetic patient care in view of increased efficiency and maintenance of quality of care: Patients' and providers' perspectives

Innovations in clinical genetics patient care This year some 40,000 patients will visit a clinical geneticist. This number is increasing because there are ever-expanding possibilities for DNA testing. Most patients are seen individually in an outpatient clinic. But partly because the healthcare budget is not growing as fast as demand, more efficient forms of providing genetic care are needed, while maintaining the care quality. Ellen Otten has looked at three innovations in genetic care provision in her PhD research: Group counselling, Online counselling, and Duty-to-Recontact. Giving genetic counselling to groups instead of to individual patients with heart problems appears to be feasible: patients were satisfied and their psychological outcomes (less fear, increased sense of control) were comparable with patients having individual counselling. However, for the counsellors it saved hardly any time or costs. Online counselling for hereditary cancer and heart diseases, using a home computer and webcam (‘Skype’) with supporting tools, appears to be much more promising and this dovetails with the increasingly digitalised society and healthcare. Despite technical problems, patients were satisfied and their psychological outcomes were comparable with those visiting outpatient clinics. Counsellors were, however, less happy, despite the fact that providing this new form of counselling did save them time. Technical improvements might help alleviate some of their concerns. Duty-to-Recontact ex-patients arises when there is new, important medical information on their condition. All parties were in favour of this development, but it was unclear how it could best be implemented in practice and will need further study. In conclusion, patients generally feel positive about these innovative forms of genetic care, although the healthcare providers need to be more convinced about several aspects before these innovations can be applied satisfactorily on a larger scale