49. INTER-PROFESSIONAL INTEGRATION TO EXPAND DELIVERY OF GENETIC SERVICES IN NEURODEVELOPMENTAL CARE

Background Genetic testing is the standard of care for individuals diagnosed with autism spectrum disorder (ASD) and intellectual disability (ID), identifying underlying genetic etiologies in up to 40% of cases and informing personalized clinical management. Despite these recommendations, prior work from our group demonstrated that ∼5% of individuals with ASD in Alberta had received recommended first-tier genetic testing. Our Precision Medicine in Autism (PRISMA) group previously developed a mainstreaming model that included a handbook, implementation resources, and subspecialty services in Psychiatric Genetic Counselling and Genomic Psychiatry to support psychiatrists in independently providing genetic counselling and ordering genetic testing. Although this model supported mainstreaming within psychiatry clinics, implementation challenges remained related to workflow integration, clinician time demands, and scalability. Methods We expanded this model through an inter-professional “hub-and-spoke” framework centred around a Psychiatric Genetic Counselling and Genomic Psychiatry clinical hub. Psychiatrists and nurses were integrated as “spokes” supporting neuropsychiatric genetics care through differentiated clinical roles. Psychiatrists independently provide pre-test counselling, order testing, and disclose negative results, while nurses support pre-test counselling, patient education, and testing workflows within physician-supervised care pathways. Clinically significant results are disclosed through the Psychiatric Genetic Counselling service.Nurses from neurodevelopmental clinics at the University of Alberta and Recovery Alberta were onboarded as implementation partners alongside psychiatrists and genetics professionals. Teams collaborated to develop nursing-specific workflows, educational materials, and consultation pathways using PRISMA handbook resources. To address implementation barriers and support care delivery, we partnered with the University of Alberta Computational Psychiatry group to develop a secure AI-supported chatbot trained on professional medical guidelines and evidence-informed genetics resources. The chatbot provides asynchronous educational support and serves as an informational primer for clinician-led discussions. The tool does not provide direct clinical care or individualized medical recommendations.Implementation outcomes are being evaluated through provider surveys, electronic health record metrics related to counselling and testing uptake, and patient/caregiver satisfaction surveys. Results Preliminary findings from the psychiatrist-focused phase demonstrated persistent workflow, time, and confidence barriers despite the availability of comprehensive educational resources. These findings informed refinement of the implementation strategy, including integration of nursing partners and expanded educational supports. Early implementation milestones included onboarding nursing champions, development of nursing-specific workflows, and integration planning within existing clinical pathways. Discussion This project addresses a critical implementation gap in neuropsychiatric genetics care by positioning nurses as key contributors to genetics mainstreaming within psychiatric and neurodevelopmental services. The PRISMA hub-and-spoke model provides a scalable framework to improve access to standard-of-care genetic testing across Alberta and beyond.