TELEHEALTH BEAT
HTRC's monthly telehealth bulletin
Genetic testing for breast cancer gets a boost in Kansas
With more than 40,000 people dying annually of breast cancer, there are few among us who have not been touched by the disease. Leading up to National Breast Cancer Awareness month in October, one University of Kansas Cancer Center effort has been working toward a lofty goal to increase genetic testing to prevent breast cancer and improve treatment for breast cancer patients. The Efficacy of Point of Service Testing in Breast Cancer (ePOST BC) program is based on the Project ECHO model , a telementoring program through which teams of experts collaborate with primary and specialty care providers to teach specialty skills.
 
The goal of this project is to reach a 50% genetic testing rate for eligible breast cancer patients. According to one of the project leaders, Jennifer Klemp, Ph.D., MPH, the ECHO model, which emphasizes democratization of knowledge, is well-suited for this project.
 
“Cancer genetics is really a perfect fit because so much of our screening, management and now treatment decisions are based on genetic information getting that into the hands of patients and providers wherever they practice is vitally important for shared decision making,” said Klemp during June’s inaugural ECHO session.
 
The purpose of the ePOST BC program is to educate cancer care providers about topics including the clinical process, guidelines and interpretation of genetic testing for breast cancer patients, cascade testing and high-risk management. Attendees have included advance practice providers (PAs & NPs), nurses, navigators and registrars. One unique aspect of this ECHO project is the quality assurance component. The leaders have developed a resource guide to assist with implementation, and participants have homework to complete between sessions.
 
In addition to educating providers, the ePOST BC program leaders emphasize the need to educate payers and patients about genetic testing.
 
Patients, said Klemp, are often feeling overwhelmed and are not excited about having to go to yet another medical office or specialist for services, which can lead to a high drop-rate when it comes to actually undergoing genetic testing. The point of service model helps alleviate some of that burden by getting patients tested where they are and then referring them to a genetic counselor if warranted by the test results. Also, it may be difficult for patients who already have breast cancer to understand why they need genetic testing. Educating patients about how the testing can benefit their treatment and help prevent cancer in loved ones is key.
The ECHOs also touched on the need for providers to educate payers about changes in genetic testing. Klemp explained that in the past, Medicare only covered one genetic test for hereditary cancer, but now that testing has improved, there may be a need for some patients to be tested again or with different types of next generation sequencing.
 
“We are going to have to be more mindful and reaching out to payers to educate them on current criteria and how we’re using genetic testing as an evidence-based service to provide access to treatment options for our patients,” said Klemp.
 
Klemp is joined on the ePOST BC ECHO team by her co-PI, Lauren Nye, M.D., and Eve-Lynn Nelson, Ph.D, who is a co-investigator. The program is supported by a grant from Pfizer Inc. and the Association of Community Cancer centers.
 
To listen to recorded ECHO sessions or see more resources on point of service testing for breast cancer patients, click on the link below:

EVENTS
National TRC Webinar: Capacity Building Through Telemedicine: Georgia Department of Public Health
October 17, 2019
1 p.m. CDT

Learn about recent developments of telehealth and telemedicine in the state of Georgia, Department of Public Health (DPH), including how DPH built its infrastructure. Discuss implementation strategies, lessons learned and strategies on how to partner with various programs to increase access to care across rural and urban settings.

NEWS ROUND UP
Do your patients know you offer telehealth ???
Probably not, according to new research from America Well. Although 23% of primary care providers reported that they offer virtual visits, only 6% of consumers were aware that their provider offered virtual visits. This disconnect points to a marketing opportunity. Providers and organizations can do more to let patients know about virtual visits and educate them about the benefits.

Senior acceptance of telehealth
New University of Michigan research highlights some areas of need for messaging to senior patients. They still need some convincing on privacy and quality of care. As mentioned in the link above, a lot of patients may not even be aware that their providers offer telehealth, so there are multiple opportunities for providers and administrators to educate patients.

New CPT codes
Several new CPT codes are expected to offer increased reimbursement for digital services in 2020, including codes for services surrounding self measured blood pressure monitoring.

SSM Health asynchronous visits
Developers of the new program say their patients are looking for convenience, not necessarily a video visit. The adaptive interview format allows patients to enter information, then return to the platform for treatment information. It has cut down provider time by 18 minutes per visit.