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PURPOSE: Given limited ambulatory access to genetics specialists, innovative service delivery solutions are needed. Electronic consultation (e-consult) programs are growing to connect clinicians to specialists. We explored the utilization and outcomes of a genetics and genomics e-consult program at Massachusetts General Hospital system in its first year.METHODS: A retrospective observational analysis of genetics e-consults ordered between April 2021 and March 2022.RESULTS: In its first year, the e-consult service triaged 153 requests and completed 122 in a median of 2.0 days. Of the 97 e-consults with actionable recommendations, there was documentation that most ordering clinicians followed through (82%). A variety of providers used the service, though the majority (77%) were generalists.CONCLUSION: e-Consult models should be considered as one way to increase access to genetics expertise.