The High-Tech High Risk Clinic

The high risk clinic is an important component of any comprehensive medical system. An effective high risk clinic employs knowledgeable staff, with the ability to assess risk, appropriately counsel, provide, and interpret cancer predisposition genetic testing, and make recommendations and assist individuals to adopt risk reduction strategies. After almost two decades after the cloning of the BRCA genes, and commercial availability and insurance coverage for testing, only a fraction of BRCA mutation carriers have been identified. We address the task of employing twenty first century technology to match the recent advances in genetics and to anticipate implementation of systems to accommodate the large numbers of individuals who will be identified as high risk. Specifically, this chapter will discuss HughesRiskApps (HRA), an integrated, open access software package originated at the Massachusetts General Hospital (MGH) and the Newton Wellesley Hospital (NWH), and that is undergoing continued enhancements through grants, philanthropy and an active user group.