ABSTRACT
Clinical services across the country were significantly disrupted earlyin 2020 due to the immense pressures for hospital beds andemergency services as a result of the COVID pandemic. At our center,all nonessential ambulatory clinical services were halted for 3.5months starting on 03/18/20 until sufficient safeguards to reopencould be established. Alternatives to traditional genetic counselingand laboratory evaluation were instituted.We will review the measures taken by our reproductive and cancergenetics clinical services to provide uninterrupted access to counselingand care. A major tool that allowed this to be accomplished wasvideo conferencing by counselors and physicians with patients whoremained at home. Several platforms were utilized with variablesuccess during this interval. We compare the number of patientencounters that our Division of Clinical Geneticswas able to provide incontrast to the number of ambulatory visits that were done across ourother departmental services.In general, the number of counseling encounters remained steadyduring the entire timespan that our campus services in lockdown orseverely restricted. There was no significant change in the number ofpatient encounters when compared to anticipated RVUs that werebudgeted, indeed, our number actually increased during mid-Springof 2020. This is in contrast to other ambulatory visits within ourdepartment of OB/GYN that were observed to decrease by approximately50% at the nadir. Laboratory testing was switched to usingmailed saliva kits when feasible, or alternate blood draw sites asneeded. Prenatal diagnostic procedures continued to be performedonsite, and that volume remained steady as well, although theindications for diagnostic testing shifted from our usual pattern, withfewer procedures being performed for maternal age indications, although this percentage returned to its usual state as the clinics liftedrestrictions.By making use of video and/or telephone conferencing, our clinicalgenetics patient encounterswere maintained at usual volumes duringthe early and mid-portion of the COVID pandemic, at a time whenmany other clinical services were disrupted. Future studies will needto include the accessibility, ease of use, and patient satisfaction withinthe tele- or videoconferencing visits. This may very well changegenetic counseling services in the future with more providers andpatients choosing telemedicine over in-person sessions for the initialcounseling interaction.