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Stay at home: implementation and impact of virtualising cancer genetic services during COVID-19
  1. Maia Leigh Norman1,2,
  2. Janet Malcolmson1,
  3. Susan Randall Armel1,3,
  4. Brittany Gillies1,
  5. Brian Ou1,
  6. Emily Thain1,
  7. Jeanna Marie McCuaig1,3,
  8. Raymond H Kim1,4
  1. 1 Familial Cancer Clinic, University Health Network, Toronto, Ontario, Canada
  2. 2 Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
  3. 3 Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
  4. 4 Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Raymond H Kim, Familial Cancer Clinic, University Health Network, Toronto, ON M5T 3L9, Canada; Raymond.Kim{at}


The COVID-19 pandemic has led to the rapid adoption of virtual clinic processes and healthcare delivery. Herein, we examine the impact of virtualising genetics services at Canada’s largest cancer centre. A retrospective review was conducted to evaluate relevant metrics during the 12 weeks prior to and during virtual care, including referral and clinic volumes, patient wait times and genetic testing uptake. The number of appointments and new patients seen were maintained during virtual care. Likewise, there was a significant increase in the number of patients offered testing during virtual care who did not provide a blood sample (176/180 (97.7%) vs 180/243 (74.1%); p<0.001), and a longer median time from the date of pretest genetic counselling to the date a sample was given (0 vs 11 days; p<0.001). Referral volumes significantly decreased during virtual care (35 vs 22; p<0.001), which was accompanied by a decreased median wait time for first appointment (55 days vs 30 days; p<0.001). The rapid virtualisation of cancer genetic services allowed the genetics clinic to navigate the COVID-19 pandemic without compromising clinical volumes or access to genetic testing. There was a decrease in referral volumes and uptake of genetic testing, which may be attributable to pandemic-related clinical restrictions.

  • genetic counseling
  • genetics
  • medical
  • genetics
  • genetic testing
  • human genetics

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  • Contributors MLN: conceptualisation; data curation; formal analysis; investigation; methodology; project administration; visualisation; writing (original draft, review, editing). JM: conceptualisation; data curation; formal analysis; investigation; methodology; project administration; visualisation; writing (review, editing). SRA: conceptualisation; supervision; writing (review, editing). BG: conceptualisation; methodology; writing (review, editing). BO: investigation; writing (review, editing). ET: conceptualisation; writing (review, editing). JM: conceptualisation; data curation; formal analysis; methodology; writing (review, editing). RHK: conceptualisation; funding acquisition; methodology; supervision; writing (review, editing).

  • Funding This manuscript was made possible through the support of The Bhalwani Family Charitable Foundation to RHK.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.