Welcome to Advances in Women’s Health on ReachMD. This medical industry feature, titled “Insights Into Successful Family Planning: A Diagnostics Perspective,” is sponsored by Quest Diagnostics.
Here’s your host, Dr. Jennifer Caudle.
Throughout the pregnancy journey, preserving maternal and fetal health is at the forefront of the minds of those clinicians treating the expectant mother. And diagnostic information services are some of the many essential pillars supporting this priority. So what’s the extent of these services, and how can certain laboratories help optimize the end-to-end experience of prenatal care?
You’re listening to Advances in Women’s Health on ReachMD, and I’m your host, Dr. Jennifer Caudle. Joining me to explore the role of diagnostic lab services within the pregnancy journey are Dr. Pat Alagia and Ms. Meredith Masiello. Dr. Alagia is the Chief Clinical Officer for Health Systems and Senior Medical Director for Advanced Diagnostics and Women’s Health at Quest Diagnostics in Secaucus, New Jersey. And Ms. Masiello is a board-certified genetic counselor at Quest Diagnostics also in Secaucus. In their roles, they often speak directly with healthcare professionals to gain a better understanding of their needs and how Quest can support them. So welcome to you both.
It’s great to be here. Thank you.
Yes, thank you for having me, Dr. Caudle and Dr. Alagia. Great to be here.
Well, we’re excited that you’re both here. And, Dr. Alagia, let's start with you, given your dual role both with Quest Diagnostics and as a practicing OB/GYN. What are your general priorities when guiding patients through the pregnancy journey?
My patients become a priority ideally before they’re pregnant, or as early on into the pregnancy as possible. The only thing that I’m focused on is the mother and the baby, and my approach is always one patient at a time. These are high-trust relationships, and I let the patient know I’ll be with her throughout her entire pregnancy.
With that said, it always starts with a discussion to learn about my patient’s history. We have about 50% of pregnancies in the United States that are unplanned, so the importance of planning in pregnancy can’t be overstated. For example, a lot of women will come into pregnancy with comorbid conditions, such as diabetes, hypertension, or thyroid disease. Or they may experience socioeconomic factors that have a negative toll on the pregnancy, such as unemployment that’s possibly causing food insecurity. So I always assess her nutritional environment to make sure that she’s eating the most nutritious foods for herself and the baby.
And then I discuss my patient’s expectations around delivery. Do you want to try a natural birth? Is this your first pregnancy? Is this your second pregnancy, or your third? What’s the interval between pregnancies?
These conversations help inform my overall approach to care throughout her pregnancy journey and helps inform which tests I’ll order for her.
Yeah, that’s very helpful. Thank you for that. And it sounds like this focus on conversations with the patient as a foundation for testing is where genetic counselors come in and make a really important impact. So, Meredith, I'd like to turn to you now. As a genetic counselor with Quest Diagnostics, what does your role look like in supporting both clinicians and their patients throughout this experience?
What’s unique about genetics is that it’s complex and it’s constantly evolving, so the screening recommendations – how much screening should be performed, and what diagnostic testing should be performed – are changing rapidly.
Given this rapid change, it’s important that clinicians understand the difference between tests from various laboratories. Because as Dr. Alagia mentioned, every patient is unique, and so genetic counselors are here to help clinicians determine what testing is appropriate for their individual patients so they can order the correct tests. We also help patients understand their genetic test results and what it means for them.
Once the results are in, we then help both the clinician and the patient understand and interpret these results. This happens in a timely fashion so that clinicians can recommend next steps to their patients as necessary.
But the bottom line is that genetics is a totally different language for some clinicians and especially for patients. And you may not always get a clear positive or negative result, there is also the possibility of a result of unknown clinical significance. But we as genetic counselors can help sort out these things and, in some cases, take the burden off the clinician if needed.
Thank you so much for that, Meredith. And if we come back to you, Dr. Alagia, what factors did you and your team at Quest find to be most important for a diagnostic company’s support of prenatal care services?
Dr. Jen, I prefer a lab that provides all the tests needed for prenatal care, such as OB panels, prenatal genetics and fetal diagnostics, just to name a few. And we’ve learned along the way that overall, it’s important for diagnostic labs to help clinicians support the mother and the baby, and there are several ways we do this at Quest. For instance, we help inform physicians, nurses and midwives by bringing them along a path to understand what tests we offer, and that our offerings are of the highest quality.
Then we have to look at the financial insurance challenges involved, including what’s covered by insurance, what will be an out-of-pocket expense, reimbursements, coding and claim submissions. We help clinicians understand these nuances, and also provide support for their office that helps reduce the administrator burden around this testing. And for patients, our dedicated patient navigator team helps answer any questions about billing and potential out-of-pocket expenses, and they even take care of all the paperwork for prior authorizations.
But our biggest issue during pregnancy is getting the patient to a clinician to get the testing they need, and it’s important that the laboratory is also supportive of helping to close those gaps for patients’ care. With the proper support, we allow healthcare professionals to do the great work needed for that mother and her baby.
And as a clinician myself, Quest can help me facilitate that engagement, to make sure that I can order the right test.
For those of you who are just tuning in, you’re listening to Advances in Women’s Health on ReachMD. I’m your host, Dr. Jennifer Caudle, and joining me to explore new insights on the end-to-end experience of prenatal care are Dr. Pat Alagia and Ms. Meredith Masiello from Quest Diagnostics.
So Meredith, let’s come back to the genetic counseling side of this journey, and dive a little deeper into the services that you and your colleagues offer. What can you tell us about this?
Well, Dr. Jen, while other laboratories offer prenatal screens, such as NIPS, many don’t offer the follow-up fetal diagnostic testing for when an abnormality is detected on this screening. So, part of our continuity of care is helping patients every step of the way, as I mentioned earlier, and we pride ourselves on this.
Quest genetic counselors follow patients and their specimens from start to finish. We are available via our Genomics Client Services line, at 866.GENE.INFO, where clinicians can call us before sending samples, after we receive the sample, while the sample is being processed, and after the test has been resulted. Abnormal prenatal test results, such as for amniocentesis or chorionic villus sampling, are always called to the ordering provider’s office.
We also have post-test consultations for patients, who can call us after they have genetic testing at Quest. We consult with patients to demystify their test results, and they don’t even need an appointment, which is actually very nice, and may also differentiate us from some other labs. The patients can simply call our Genomic Client Services line, at 866.GENE.INFO, during normal business hours, and they’re always going to talk to a live person.
So, I think that these are just some important steps that Quest takes to make the pregnancy journey a little bit smoother for healthcare professionals, and a little less anxiety-provoking for the patients.
Well, we’ve certainly covered a lot of ground here today, but before we close, I’d like to get a final thought or two from each of you. So Dr. Alagia, starting with you, what do you want our listeners to take away from today’s discussion?
One of the things I wanna be sure to say is that testing itself is secondary. We are all responsible for this pregnancy journey for the mothers, for the babies and the families. It’s not just the lab, it’s not just the doctor. It’s the entire community, and the sooner we understand that, and embrace that as a society, the better off we’re all gonna be.
But we have more work to do, and I think that Quest commitment to this is unsurpassed in the industry.
Thank you so much for that, Dr. Alagia. And Meredith, you get the final word.
So, it’s not unusual for a clinician to say, “Wow, Quest. I never thought of you for genetic testing,” because Quest is one of the largest national laboratories. But in terms of genetic testing, we’re a small piece of the large lab, and I always try to get this point across. Healthcare professionals are often surprised to learn that we’re a small, boutique-like genetic testing lab in a big, national company.
And we really wanna get the message across to clinicians, and to patients, that we’re here for them. We know that there’s a patient behind every sample that we receive, so we’re doing everything possible to get the most accurate test results in the shortest period of time, to help these pregnant patients with their journey.
Well, those are really great comments for us to keep in mind as we end today’s program, and I’d like to thank my guests, Dr. Pat Alagia and Ms. Meredith Masiello, for helping us better understand the supportive role that diagnostic labs can have for clinicians and patients across the pregnancy journey.
Dr. Alagia and Meredith, it was great speaking with you both today. Thanks again.
Dr. Caudle, Meredith, thank you so much for allowing me to be part of this podcast, but most importantly, I wanna thank my colleagues for the great work they are doing every day.
Dr. Caudle and Dr. Alagia, it was my pleasure to be here as well. Thank you all.
This medical industry feature was sponsored by Quest Diagnostics. If you missed any part of this discussion, visit ReachMD.com/AdvancesinWomensHealth. This is ReachMD. Be Part of the Knowledge.