(A) Study enrollment and follow-up timeline. July 2018 NCCN and November 2018 ASCO refer to published recommendations22,23 for genetic testing of patients with PDAC. (B) Schematic of the clinician-directed referral process. (C) Schematic of the automated referral process. See the script (Data Supplement). (D) Subject enrollment during the two referral periods. DFCI, Dana-Farber Cancer Institute; EMR, electronic medical record; GEN, cancer genetics department; GC, genetic counseling; MGT, multigene germline testing; ONC, oncology department; NPC, new patient coordinator; PDAC, pancreatic ductal adenocarcinoma.