Project Search

The BC Ministry of Health has identified several public health sector challenges: a growing and aging population, health needs that are increasingly complex, and increased demands on an already strained health sector workforce. These factors combine to increase pressure on family physicians and the healthcare system. By targeting the individual needs of the patient and thereby increasing the efficiency of health care delivery and improving patient outcomes, precision medicine has the potential to address these concerns. 

However, precision medicine approaches involve new technologies — genomic sequencing, population screening, pharmacogenomic testing — that make healthcare delivery more complex. As of 2023, most clinical genetic services are provided by specialist clinicians in urban, tertiary care centres. Tertiary genetics care has long wait times, access barriers, and inequitable utilization. Primary care can lead to more equitable distribution of health in populations and improved functioning of health services through coordinated access. For this reason, it is generally expected that family physicians working in primary care settings are ideally placed to deliver the benefits of precision medicine, including the implementation of genetic and genomic technologies. Yet primary care is already under great stress in all Canadian regions and many family physicians report being unprepared or unable to provide genetics healthcare. 

The integration of genetic counsellors (GCs) into primary care settings is a potential solution. GCs are Master’s trained healthcare professionals who are specialists in clinical genetic services but currently, most genetic counsellors work in hospitals or specialty tertiary clinics. The ACCESS-GC trial will embed a genetic counsellor into a family physician’s clinic for two years, where they will work with the family physician to provide team-based care for patients who are attached to the clinic, and have, or are at-risk for a condition that has a genetic component, including both rare genetic, and common complex conditions (e.g. psychiatric conditions, diabetes). The goal is to determine whether this model of care can improve patient and provider experiences, improve patient health, provide economic benefits and advance health equity, and to propose clinical pathways for the integration of genetic counsellors into primary care settings.