Assessment of local provider engagement of an in-home collaborative model for remote genetic services.

Purpose: Clinical genetic testing demand has increased in the era of precision medicine. However, the availability of cancer genetic services remains limited in the United States, prompting a rise in telehealth delivery. Through our Telegenetics program, we seek to promote genetic service delivery across the United States, and here, we assess engagement through registrations with local providers using a service delivery model. Methods: This report describes the Penn Telegenetics Program experience across 4 research and clinical activities using an in-home collaborative local provider model. We report the clinical procedures and our initial experience implementing this model across these 4 research and clinical activities in the Penn Telegenetics Program. We present descriptive findings of the registrations and, in cases of refusals, the rationale provided. Results: From 2018 to 2025, 473 providers (89.4%) successfully registered. Providers were predominantly MD/DO licensed (85.0%). Family medicine was the most frequent specialty (54.3%), followed by internal medicine (20.9%) and clinical oncology (11.8%). Most providers were in suburban locations by zip codes (56.2%); 20.1% were in rural zip codes. Only 56 providers declined collaboration (10.6%); the most common reasons reported were preferring local genetic services (22.5%) and not being comfortable as the ordering provider (22.5%). Conclusion: Our data demonstrate that most local providers are willing to collaborate with a centralized telegenetics program. Still, subsequent engagement from local providers in follow-up questions or other referrals remains a missed opportunity to improve telegenetics access. Refining procedures to increase collaborative care and engagement may provide opportunities to increase access to cancer genetic testing.