Improving Molecular Genetic Test Utilization through Order Restriction, Test Review, and Guidance

The Journal of Molecular Diagnostics : JMD
Jacquelyn D RileyFelicitas L Lacbawan

Abstract

The ordering of molecular genetic tests by health providers not well trained in genetics may have a variety of untoward effects. These include the selection of inappropriate tests, the ordering of panels when the assessment of individual or fewer genes would be more appropriate, inaccurate result interpretation and inappropriate patient guidance, and significant unwarranted cost expenditure. We sought to improve the utilization of molecular genetic tests by requiring providers without specialty training in genetics to use genetic counselors and molecular genetic pathologists to assist in test selection. We used a genetic and genomic test review process wherein the laboratory-based genetic counselor performed the preanalytic assessment of test orders and test triage. Test indication and clinical findings were evaluated against the test panel composition, methods, and test limitations under the supervision of the molecular genetic pathologist. These test utilization management efforts resulted in a decrease in genetic test ordering and a gross cost savings of $1,531,913 since the inception of these programs in September 2011 through December 2013. The combination of limiting the availability of complex genetic tests and providing...Continue Reading

References

Oct 3, 2013·Clinica Chimica Acta; International Journal of Clinical Chemistry·Katrina E KotzerMcKinsey L Goodenberger
Mar 26, 2014·American Journal of Medical Genetics. Part a·Christine E MillerDanielle Lagrave

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Citations

Jul 31, 2016·American Journal of Clinical Pathology·Patrick C MathiasJane A Dickerson
Jan 27, 2017·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Carlos J SuarezDavid A Stevenson
Mar 21, 2017·American Journal of Medical Genetics. Part a·Gina K LondreJessie H Conta
Oct 6, 2017·Archives of Pathology & Laboratory Medicine·Yaolin ZhouJacquelyn D Riley
Jan 7, 2017·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Jennifer L Hunt
Apr 11, 2018·American Journal of Clinical Pathology·Jacquelyn D RileyGary W Procop
May 2, 2020·Journal of Genetic Counseling·Kathleen MontanezMonica A Lutgendorf
Mar 24, 2018·Journal of Genetic Counseling·McKinsey L GoodenbergerTeresa Kruisselbrink
Oct 31, 2019·American Journal of Clinical Pathology·Jacquelyn D RileyGary W Procop
Mar 19, 2020·Neurology. Genetics·Samuel J MackenzieBrian C Callaghan
Jan 22, 2021·American Journal of Medical Genetics. Part a·Louise Amlie-WolfKaren W Gripp
Mar 18, 2021·Journal of Genetic Counseling·Michele C KiekeLindsay H Zetzsche
Nov 10, 2021·Critical Reviews in Microbiology·Valentin ScherzClaire Bertelli
Dec 7, 2021·Clinical Chemistry·Andrew E O Hughes, Ronald Jackups

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