Dr. Melissa Frey, a gynecologic oncologist, cancer geneticist, and researcher based in New York City, uses digital tools to streamline family history intake, assess cancer and hereditary risk, and improve documentation.
We’ve previously covered Dr. Frey’s work showing how digital history collection improved documentation and risk assessment in GYN oncology (blog here) and how applying breast risk models in survivorship care uncovered additional patients who might benefit from prevention or early detection (blog here). Dr. Frey has used both Progeny and the Ambry CARE Program® (CARE) and shared insights on why digital tools are needed as well as where they may best fit.
Risk Assessment Barriers
Risk assessment matters—both for increased lifetime cancer risk and for inherited cancer predisposition. Identifying elevated cancer risk can change screening and risk reduction options. Hereditary risk also has implications for family members.
Yet in practice, it can be hard to do in busy clinical settings. Collecting a complete family history takes time; genetics training varies across clinicians; and guidelines evolve fast.
As Dr. Frey shared,
Providers believe cancer risk assessment is important and beneficial for patients, but many say, ‘I don’t have the training to counsel my patients about this,’ or ‘It’s impossible to keep up with the ever-changing guidelines.
Where Digital Tools Fit
Digital tools can move key steps upstream—letting patients enter history before the visit. They can automate the generation of guideline‑based insights for the clinician, and in some cases, standardize documentation. Used well, they reduce guesswork about who needs testing or enhanced screening.
Progeny & CARE: Two Tools, Two Use Cases
Progeny is often used as a central genetics hub. It may be best suited for genetics professionals and other clinical teams that want comprehensive risk assessment options and/or genetics workflow support.
Progeny supports:
- Pre‑visit history collection with patient questionnaires
- Pedigree drawing with customization and EHR connectivity
- Risk assessment using multiple validated models for hereditary and lifetime cancer risk
- Documentation (clinic notes, letters) and reporting to support practice management and research
- Genetic test ordering/resulting via Ambry and documentation of test results from other genetic testing labs
These capabilities help teams capture complete histories, run nuanced models, and keep documentation consistent across encounters.
CARE (“Comprehensive Assessment of Risk and Education”) is often used in routine care environments like OB/GYN, mammography, and primary care where the goal is to quickly flag patients who may qualify for genetic testing or need a high-risk breast care referral.
CARE supports:
- Pre‑visit digital history collection
- Guideline‑based testing qualification and Tyrer–Cuzick breast risk scoring
- Genetic testing offered through Ambry, with results delivered in CARE and/or EHR
- Digital patient education and connection to third‑party telehealth genetic counseling
Clinicians often appreciate CARE’s focused outputs and clear prompts—Dr. Frey describes it as a tool that “quickly flags whether genetic testing or breast cancer risk discussions are needed.”
Choosing the Right Fit & Getting Started
If you need comprehensive genetics workflows—pedigrees, multi‑model assessment, and robust documentation and reporting—Progeny is typically the better match.
If you need standardized high‑risk identification at scale in routine clinics and with wraparound education/connection to counseling, CARE may be a better fit.
With any digital tool, implementation takes some upfront effort: mapping workflows, connecting to the EHR as needed, and socializing the process with care teams. But once embedded, teams report better use of time in clinic, more consistent documentation, and clearer next steps for patients. As Dr. Frey puts it:
There is some work upfront, but this becomes a routine part of practice that actually makes care faster and more efficient.
The Bottom Line
In a study assessing almost 20,000 patients using CARE in a community hospital setting, approximately one in four patients met national guidelines for hereditary cancer testing.1 However, many patients meeting testing criteria have historically been missed in routine care. Bringing digital history collection and guideline‑based assessment into everyday workflows helps close that gap—so higher‑risk patients get the right conversations and the right care at the right time.
1. https://ascopubs.org/doi/10.1200/JCO.2023.41.16_suppl.10622
