Regional models of genetic services in the United States.

PURPOSE: To outline structures for regional genetic services support centers that improve access to clinical genetic services. METHODS: A workgroup (WG) and advisory committee (AC) (1) conducted a comprehensive review of existing models for delivering health care through a regional infrastructure, especially for genetic conditions; (2) analyzed data from a needs assessment conducted by the National Coordinating Center (NCC) to determine important components of a regional genetic services support center; and (3) prioritized components of a regional genetic services support system. RESULTS: Analysis of identified priorities and existing regional systems led to development of eight models for regional genetic services support centers. A hybrid model was recommended that included an active role for patients and families, national data development and collection, promotion of efficient and quality genetic clinical practices, healthcare professional support for nongeneticists, and technical assistance to healthcare professionals. CONCLUSION: Given the challenges in improving access to genetic services, especially for underserved populations, regional models for genetic services support centers offer an opportunity to improve access to genetic services to local populations. Although a regional model can facilitate access, some systemic issues exist-e.g., distribution of a workforce trained in genetics-that regional genetic services support centers cannot resolve.

Correction: Regional models of genetic services in the United States.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Colocating health services: a way to improve coordination of children's health care?

Pediatric practices are faced with a growing demand that they address the healthy development of their patients. As pediatric practices strengthen their role as medical homes for their patients, they need either to provide expanded services or enhance their capacity to coordinate that care. One option for enhancing the existing capacity of pediatric practices is colocation with other providers and services in the same setting. This issue brief examines what is currently known about the use of colocation and its benefits. The literature and interviews used as information resources for the brief suggest that colocation of services is not a single strategy but rather a complex set of relationships, organizational structures, and other features meant to help practices deliver effective care. However, more thorough examination of current colocation approaches is needed before advice can be provided to practices considering this option.