Evaluation of Patient and Provider Satisfaction with a Point of Care Genetic Testing Model for Cancer Patients

Abstract

The ever-increasing demand for cancer genetics services is driven by expanded patient eligibility criteria and the utility of hereditary cancer genetic testing (HCGT) in informing treatment plans and long-term risk management. This demand is currently unmet due to the limited supply of genetic counselors; therefore, alternative service delivery models are being explored to improve access to HCGT. This study used a mixed-methods approach to concurrently evaluate patient and provider satisfaction with a point-of care testing (POCT) model at NYU Langone Health. In this POCT model, cancer patients who were eligible for HCGT received pretest education from an educational video and handout before discussing and consenting to HCGT with their oncology provider. Genetic counselors provided post-test genetic counseling and risk assessment. Patient satisfaction was evaluated via post-test surveys for two study arms, POCT and Non-POCT. Chi-square analysis was used to evaluate differences in satisfaction survey responses between arms. Provider satisfaction was evaluated via a survey using a mixed-methods approach involving descriptive statistics and reflexive thematic analysis of free-text responses. In total, 116 patients (Non-POCT=63 and POCT=53) and 25 providers completed their respective satisfaction surveys between August 2023 and January 2024. There were no significant differences in patient satisfaction between POCT and Non-POCT arms in all survey categories. Similarly, there were no significant differences when comparing patient satisfaction between breast and non-breast cancer patients within the POCT arm. Providers reported high satisfaction and competency with the POCT model. Overall, 57% percent of providers found it easy to use, 71% felt comfortable identifying eligible patients, and 60% felt comfortable obtaining informed consent. Providers also perceived high patient satisfaction as 85% reported that patient satisfaction was either unchanged or significantly increased. Providers’ perceived benefits of POCT included expedited HCGT results while barriers included time and/or space constraints. Overall, the patient and provider responses observed in this study provide evidence for the successful implementation of a POCT model for cancer patients pursuing HCGT