A Balancing Act—Telehealth Cancer Genetics and Practitioners’ Experiences of a Triadic Consultation
Telehealth is increasingly used for outreach service in cancer genetic counseling; however what occurs during the consultation and the roles practitioners adopt is largely unknown. Fifteen practitioners participated in semi-structured interviews that explored their roles within telehealth, compared to face-to-face consultations, and the relationship between practitioners during telehealth. As they were not physically present with the patient, most participants felt that telehealth altered the genetic clinician’s role to one of a ‘visiting specialist’. Genetic counselors described undertaking multiple roles during the telehealth process. Two models of interaction were observed. The medical model reduced the interaction to a dyadic consultation by having the genetic counselor off-screen and included minimal clinician meetings and supervision. The triadic co-facilitation model incorporated a high level of information exchange, counselor autonomy and included the counselor onscreen. The co-facilitation model offers a useful framework for telehealth genetic counselling, offering complementary roles between practitioners and efficient service delivery.
KeywordsGenetic counseling Telehealth Cancer Triadic relationship
We are most grateful for the valuable contribution of all the genetic counselors and genetic clinicians who participated in the project as informants and to Dr Shab Mireskandari, Dr Tracey Dudding, Associate Professor Judy Kirk and Ms Linda Warwick for their input into the development of this project. A/Professor Bettina Meiser is supported by an NHMRC Career Development Award (ID 350989). This research was funded through a Strategic Research Partnership Grant from the New South Wales Cancer Council (SRP 06-X5).
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