Service Outcomes for Germline Test Delivery for Patients With Metastatic Prostate Cancer

How do service outcomes for germline testing compare under different delivery models?In this national quality improvement study of 1964 patients with metastatic prostate cancer, compared with the traditional approach of genetic consultation, embedding genetics clinicians within oncology clinics was associated with greater estimated effectiveness, efficiency, and timeliness, although limited by staffing availability. Mainstreaming (oncologists performed all testing activities) was associated with greater efficiency and timeliness, although difficult to establish, and partial mainstreaming (oncologists performed some testing activities) was associated with less efficiency and more fragmented care.These findings may be helpful to health care organizations planning germline testing implementation.

Corresponding Author: Maren T. Scheuner, MD, MPH, San Francisco VA Health Care System, Genomic Medicine Service, Sierra Pacific Network Clinical Resource Hub, 4150 Clement St, San Francisco, CA 94121 (maren.scheuner@va.gov).

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