Abstract B072: Promoting access to in-home cancer genetic testing through a primary care collaborative telegenetics model

Abstract Background: Given the exponential growth of genetic testing and the limited number and availability of genetic counselors, particularly in rural areas, there has been interest in using telehealth to promote accessibility equity to genetic services. Methods: The Penn Telegenetics Program (PTP) is a research program developed in 2012 to increase access to genetic services for low-access populations and community practices without genetic counselors. In 2021, we developed the primary care provider (PCP) collaborative model to address the limitations of the on-site model, allowing patients across the US to access remote Telegenetics services. In this model, interested patients provide the name of their local provider. The PTP contacts the local provider to share information about the program and remote genetic services and asks if the provider is willing to collaborate with the team to order genetic testing (e.g. register with PTP). Genetic counselors share chart notes and results with collaborating providers after returning results and are available to answer any clinical questions from providers upon request. To evaluate the success of this care model, we record all provider contacts and outcomes, provider inquiries and subsequent referrals. Results: Across 4 studies employing the in-home collaborative PCP model, 529 providers were contacted, and 473 providers (89.4%) successfully registered to collaborate and facilitate testing for their patients. Providers were predominately MD/DO licensed (85.0%), with slightly more representation among female providers (56.2%), and half came from a group practice (51.0%). PCPs (e.g. family medicine, internal medicine and gynecology) represented the majority of specialties (85%), with clinical oncology being second (11.8%). Most providers were in suburban (56.2%) or rural (20.1%) zip codes. Although provider refusals were rare, of the 56 refusals (10.6%), the most frequent reasons reported by PCPs (which could have been more than one) included: discomfort with being an ordering provider for genetic testing (38.6%), preference for local genetic testing services (28.6%), or requesting to see or discuss with the patient first (17.9%). In the remainder of refusal cases the provider had a discussion with the patient, and they developed an alternative plan for local testing (17.9%). There were no provider requests for additional information nor subsequent referrals from collaborating providers. Conclusion: Most local providers were willing to collaborate with central telehealth provider and promote patient accessibility to germline cancer genetic testing. While only a small number of providers declined, it is crucial to understand their perspective to increase access to in-home services. As such, we plan to interview providers to understand their perception of the PTP, how they use of results for medical care, and their overall experience with program. The lack of provider engagement and referrals represent a missed opportunity to increase access to genetic services in community settings. Citation Format: Daniel Chavez-Yenter, Tara O. Henderson, Brian Egleston, Elisabeth McCarty Wood, Sarah Howe, Sarah Brown, Janice Christiansen, Cara Cacioppo, Michelle Weinberg, Rajia Mim, Demetrios Ofidis, Dominique Fetzer, Angela Bradbury. Promoting access to in-home cancer genetic testing through a primary care collaborative telegenetics model [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B072.