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Positive impact of genetic counseling assistants on genetic counseling efficiency, patient volume, and cost in a cancer genetics clinic



Cancer genetics clinics have seen increasing demand, challenging genetic counselors (GCs) to increase efficiency and prompting some clinics to implement genetic counseling assistants (GCAs). To evaluate the impact of GCAs on Geisinger’s cancer genetics clinic, we tracked GC time utilization, new patient volume, and clinic cost per patient before and after implementing a GCA program.


GCs used time-tracking software while completing preappointment activities. Electronic health records were reviewed for appointment length and number of patients per week. Internal salary data for GCs and GCAs were used to calculate clinic costs per patient.


Time spent by GCs completing each preappointment activity (21.8 vs. 15.1 minutes) and appointment length (51.6 vs. 44.5 minutes) significantly decreased after GCA program implementation (p values < 0.001). New patients per week per GC significantly increased (7.9 vs. 11.4, p < 0.001). Weekly clinic cost per patient significantly decreased ($233 vs. $176, p = 0.03).


Implementing a GCA program increased GC efficiency in preappointment activities and clinic appointments, increased patient volume, and decreased clinic cost per patient. Such a program can improve access to GC services and assist GCs in focusing on the direct patient care for which they are specially trained.

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Fig. 1: Fishbone diagram of clinic workflow and genetic counselor (GC) time tracking.
Fig. 2: Genetic Counselor (GC) time spent pre- and post-Genetic Counselor Assistant (GCA) implementation.


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Special thanks to our genetic counseling colleague, Audrey Fan, for her efforts to begin and evaluate the GCA program at Geisinger. The authors also acknowledge the funding support of Geisinger Research and Hematology/Oncology departments.

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Correspondence to Miranda L. G. Hallquist MSc.

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M.R. is a stockholder of Helix, LLC. The other authors declare no conflicts of interest.

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Hallquist, M.L.G., Tricou, E.P., Hallquist, M.N. et al. Positive impact of genetic counseling assistants on genetic counseling efficiency, patient volume, and cost in a cancer genetics clinic. Genet Med 22, 1348–1354 (2020).

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  • genetic clinic efficiency
  • genetic counseling assistants
  • cancer genetic counseling
  • service delivery
  • access

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