The Ontario Epilepsy Genetic Testing Program [OEGTP]

On October 1, 2020, the Ontario Ministry Health [MOH] established epilepsy gene panel testing in Ontario as a publicly funded service for patient’s who meet the ministry’s eligibility criteria. Therefore, after this date, the MOH’s Out-of-Country/Out-of-Province (OOC/OOP) Prior Approval Program for Laboratory Testing will no longer be accepting applications for epilepsy panel testing and ordering physicians will be redirected to the testing provided in Ontario.

Specifically, based on the recommendations of an MOH epilepsy genetics advisory group, the Ontario Epilepsy Genetics Testing Program [OEGTP] will provide evidence-based epilepsy gene panels for properly selected epilepsy patients(1).This genetic testing will be carried out at the Division of Molecular Diagnostics in the Pathology and Laboratory Medicine Department(2) at London Health Sciences Centre.

Project ECHO Epilepsy Across the Life Span and the OGETP.

With the advent of OGETP Epileptologists and Neurologists affiliated with Ontario District and Regional Epilepsy Centres, FRCP Neurologists with a minimum of six months of training in epilepsy and EEG, and Geneticists can order genetic testing in epilepsy patients. In addition, Ontario licensed physicians who acknowledge completion of the Continuing Medical Education (CME) certified epilepsy genetics curriculum in Project ECHO Epilepsy Across the Life Span will be able to order genetic testing for their epilepsy patients, where indicated, through the OEGTP. Project ECHO Epilepsy Across the Lifespan is a provider education opportunity targeted at Family Physicians, Paediatricians and Community Neurologists.

Project ECHO® (Extension for Community Healthcare Outcomes) is an innovative model for medical education that uses video-conferencing with case-based learning to connect specialist multidisciplinary teams at academic health centres to community healthcare providers. In this way Project ECHO: Epilepsy Across the Lifespan delivers pediatric and adult epilepsy curricula to improve the quality and accessibility of epilepsy care in Ontario. The genetics of epilepsy now is an integral part of the Project ECHO Epilepsy Across the Life Span curricula. This epilepsy genetics curricula may be found on our website and will be provided in our next ECHO cycle in February 2021.

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Accessing Epilepsy Genetic Testing.

Access to epilepsy genetic testing now is available through a new requisition (3) that is designed to provide information critical to interpretation of the genetic test results and genetics counseling. As well, the health care provider who orders the genetic epilepsy test and receives the result will be required to complete the OEGTP Management impact form (4), which will provide data concerning the impact of results of epilepsy genetic testing using multigene panels on patient management. These management impact data are critical to ongoing evidence-based analysis and clinical oversight of the OEGTP with resultant expert guidance used for continuously improving the service for better patient care and impact going forward.