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      Transitioning to telegenetics in the COVID‐19 era: Patient satisfaction with remote genetic counseling in adult neurology

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          Abstract

          The COVID‐19 pandemic rapidly changed genetic counseling services across the United States. At the University of Pennsylvania (UPenn), a large academic hospital in an urban setting, nearly all genetic counseling (GC) visits for adult–onset disorders within the Department of Neurology were conducted via secure videoconferencing (telegenetics) or telephone between March and December 2020. Although telemedicine services have been steadily emerging, many clinical programs, including the neurogenetics program at UPenn, had not built infrastructure or widely utilized these services prior to the pandemic. Thus, little is known about patient attitudes toward receiving clinical GC services remotely. From May 18 to October 18, 2020, all individuals seen remotely for GC in adult neurology via telephone or telegenetics were surveyed about their satisfaction with telehealth GC ( N = 142), with a response rate of 42% ( N = 60/142). Telephone and telegenetics services were referred to as ‘telehealth’ in the surveys to capture patient perspectives on all remote GC services, though the majority ( N = 49/60) of these visits were completed via telegenetics. Surveys included the modified telehealth usability questionnaire (MTUQ), genetic counseling satisfaction scale (GCSS), and novel questions about future telehealth use. Preliminary results suggest that patients were satisfied with receiving remote GC services in adult neurology, with most participants strongly agreeing to all items about satisfaction with telehealth. Just 2% of participants preferred only in‐person visits in the future, but every participant was willing to consider using telehealth for future visits if their genetic counselor felt it was appropriate. Most participants preferred a hybrid model (73%), and some (25%) preferred only telehealth for future visits. Additionally, we found no differences in satisfaction with remote services based on visit type (initial vs. results disclosure) nor age. We conclude that remote GC is an acceptable method for the provision of services in adult neurology that is well‐received by patients.

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          Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support.

          Research electronic data capture (REDCap) is a novel workflow methodology and software solution designed for rapid development and deployment of electronic data capture tools to support clinical and translational research. We present: (1) a brief description of the REDCap metadata-driven software toolset; (2) detail concerning the capture and use of study-related metadata from scientific research teams; (3) measures of impact for REDCap; (4) details concerning a consortium network of domestic and international institutions collaborating on the project; and (5) strengths and limitations of the REDCap system. REDCap is currently supporting 286 translational research projects in a growing collaborative network including 27 active partner institutions.
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            The REDCap consortium: Building an international community of software platform partners

            The Research Electronic Data Capture (REDCap) data management platform was developed in 2004 to address an institutional need at Vanderbilt University, then shared with a limited number of adopting sites beginning in 2006. Given bi-directional benefit in early sharing experiments, we created a broader consortium sharing and support model for any academic, non-profit, or government partner wishing to adopt the software. Our sharing framework and consortium-based support model have evolved over time along with the size of the consortium (currently more than 3200 REDCap partners across 128 countries). While the "REDCap Consortium" model represents only one example of how to build and disseminate a software platform, lessons learned from our approach may assist other research institutions seeking to build and disseminate innovative technologies.
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              Is Open Access

              Patient Characteristics Associated With Telemedicine Access for Primary and Specialty Ambulatory Care During the COVID-19 Pandemic

              Key Points Question What sociodemographic factors are associated with higher use of telemedicine and the use of video (vs telephone) for telemedicine visits for ambulatory care during the coronavirus disease 2019 (COVID-19) pandemic? Findings In this cohort study of 148 402 patients scheduled for primary care and medical specialty ambulatory telemedicine visits at a large academic health system during the early phase of the COVID-19 pandemic, older age, Asian race, non-English language as the patient’s preferred language, and Medicaid were independently associated with fewer completed telemedicine visits. Older age, female sex, Black race, Latinx ethnicity, and lower household income were associated with lower use of video for telemedicine care. Meaning This study identified racial/ethnic, sex, age, language, and socioeconomic differences in accessing telemedicine for primary care and specialty ambulatory care; if not addressed, these differences may compound existing inequities in care among vulnerable populations.
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                Author and article information

                Contributors
                tanya.bardakjian@pennmedicine.upenn.edu
                Journal
                J Genet Couns
                J Genet Couns
                10.1002/(ISSN)1573-3599
                JGC4
                Journal of Genetic Counseling
                John Wiley and Sons Inc. (Hoboken )
                1059-7700
                1573-3599
                15 July 2021
                August 2021
                15 July 2021
                : 30
                : 4 , COVID‐19 Special Issue ( doiID: 10.1002/jgc4.v30.4 )
                : 974-983
                Affiliations
                [ 1 ] Department of Neurology Neurogenetics Translational Center of Excellence University of Pennsylvania Philadelphia Pennsylvania USA
                Author notes
                [*] [* ] Correspondence

                Tanya Bardakjian, Department of Neurology, Neurogenetics Translational Center of Excellence, University of Pennsylvania, Philadelphia, PA, USA.

                Email: tanya.bardakjian@ 123456pennmedicine.upenn.edu

                Author information
                https://orcid.org/0000-0003-0801-2631
                Article
                JGC41470
                10.1002/jgc4.1470
                8427091
                34265143
                88c7ffc3-9825-4b01-9d25-47d96e5066d1
                © 2021 National Society of Genetic Counselors

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 17 June 2021
                : 12 January 2021
                : 20 June 2021
                Page count
                Figures: 4, Tables: 1, Pages: 10, Words: 7010
                Categories
                Special Issue
                Specialty Clinics
                Custom metadata
                2.0
                August 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.7 mode:remove_FC converted:09.09.2021

                Genetics
                covid‐19,genetic counseling,neurogenetics,telegenetics,telehealth,telemedicine
                Genetics
                covid‐19, genetic counseling, neurogenetics, telegenetics, telehealth, telemedicine

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