In an interview with Oncology Learning Network, Rachel McConachie, RN, BSN, Director of Clinical Operations, Dignity Health Cancer Institute of Greater Sacramento, California, discusses how her cancer center has adapted to providing patients with telemedicine-driven genetic counseling.

When did you realize that the COVID-19 infection was going to impact the provision of cancer care?

Immediately. People living with cancer are so vulnerable and at the peak of the pandemic we realized that there were a lot of barriers to overcome. These barriers were not only operational but there were also practical issues for many of our patients.

We helped patients by delivering groceries, picking up prescriptions, and offering support groups, nutritional consults, counseling and nurse navigation services all by zoom. We were also fortunate that the majority of our cancer conferences had already transitioned to a virtual platform so patient care was not disrupted.

Our biggest concern has been about the drop in routine screenings, however, in recent months we are seeing an uptick and continue to reassure the community it is safe to continue with routine appointments and screening is very important.

How has your cancer institute adapted to providing remote care, particularly with regards to telegenetic counseling?

We were very fortunate that we already had a telegenetic counseling service in place. We have 3 genetic counselors in 3 different states, and we really weren’t impacted by COVID-19; referrals dropped off a little, but we were able to catch up with all of our backlog.

The patients prefer being able to receive services in the comfort of their own home, they have so many appointments and this is one less trip to clinic.

What are some of the short- and long-term benefits of utilizing telegenetic counseling? Who benefits the most from the service, and why?

As an organization, we benefit from telegenetic counseling in a number of ways.

Firstly, with only 700 oncology focused genetic counselors in the nation we have been able to recruit and retain 3 incredibly talented individuals.

The ability to work remotely is appealing for many, particularly with life changes such as moving, starting a family, etc. Having a healthy work-life balance is really important, particularly as there is a high risk for burn-out in the field of genetics.

The other benefits are being available to support oncology clinics in more remote locations who don’t have the volume for a full-time genetic counselor or are unable to recruit.

Most importantly, the patients benefit with the opportunity to have their appointment from the comfort of their home, there is also no inconvenience of going to a lab as we use a mobile phlebotomist.

What changes does your cancer institute have planned when looking toward a post-pandemic future?

We will continue to see patients both within our division and outside. Telegenetics have enabled us to support our sister facilities in other parts of northern California.

We are also piloting a screening tool with our OBGYN physicians to identify high risk patients early on. Our long-term vision is to develop a high-risk clinic so that those with a high risk for developing cancer are identified early on.