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Client Driven Service...  based on your Product, your Requirements  
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**a Community Hospital wishes to establish a regular Genetics Clinic to support the needs of its Surgical and Family Practice providers, and to comply with Commission on Cancer recommendations for a developing accredited Oncology Program.   It is expected that this service will draw patients and their families into the hospital network for follow-up care and clinical services.  On-site and remote Genetic Counseling services have been shown to impact utilization of hospital services related to preventative oncology surgery, increased enrollment of family members into the Clinic system and in providing patients with the familiarity of a hospital that will provide them care in the years to come. Preliminary tracking review indicates that the Genetics Service is generating downstream revenue beyond initial expectations.

 **A Medical Center satellite office requests offsite and on site web-based genetic counseling for a new specialty clinic.   A future budget would allow a full time in-house employee to be assigned to this clinic,  but it's important that this clinic start seeing patients now, to satisfy clinical caseload and  American College of Surgeons recommendations for Genetic Counselor inclusion on the Cancer Risk Team.  We designed a system for Patient Check-In,  collection of family history information and scheduling to accommodate the budget and needs of this service.
 
 ** a Medical Insurer with Regional and National breadth, requested Genetic Counselor expertise for Policy Review and Case Review, to insure efficient and appropriate use of the expanding options in  genetic testing from both Clients and Providers.   We provided a review of their Cost and Utilization, looking at established guidelines and variations in practice, towards providing recommendations for Genetic Testing Policy Updates. In collaboration with We offered the Services of Genetic Counselors with expertise in this area, on an hourly basis, with a 6 month contract.  Segments of the Policy for Review were decided by the Insurer on a Monthly basis, and as needed.  This contract was written to allow for variable workload from week to week, as needed. 

 
 
**An International  Laboratory desires web based consultation for clients at one of its foreign locations.  A system for scheduling, record collection and physician engagement is organized.  A team that is educated on the needs of this assignment is created, placing a clinic in a few weeks time.  Weekly meetings keep everyone on this assignment up-to-date.   
 


Discussions with a genetic counselor as offered by Genetic Laboratories and Genetic Testing Companies serve to provide key information for the understanding of genetic testing, although pedigree intake and record review may be focused to the results of genetic testing.  Although laboratory license and permit and genetic counselor certification and licensure where applicable, do not permit the practice of medicine, genetic counselors can provide explanation and direction to physicians and authorized medical professionals for the interpretation of the results of genetic testing.  Genetic counselors, upon physician waiver and in collaboration with ordering clinicians, can provide counseling on genetic testing and the meaning of test results. Comprehensive genetic counseling may be available through physicians who can provide genetic counseling within the scope of their practices as they choose and through genetic counselors within the scope of their practice. Please note that patient management and genetic counseling surrounding on-going prenatal or any diagnostic testing is best handled by Physicians, Maternal/Fetal and Pediatric Genetics specialists,  in conjunction with clinical services where they are available and in collaboration with genetic counselors and other genetic specialists. 

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