Start with the exact question your home team needs answered
A common failure in cross-border WES planning is sending a large file without a question. The Chinese laboratory or clinical team receives a report, but no one knows whether the home team wants a sequencing review, a reanalysis of existing data, a records-based opinion, or simply confirmation that a sample can be accepted. Those are different requests, and they produce different replies.
Write the question in one or two sentences before you send anything. For example: 'We have an existing exome report and a variant of uncertain significance; can the receiving team review the raw data and report against the current clinical summary?' Or: 'We are considering WES in China and need to know what sample type and documentation the laboratory requires from an overseas patient.' The question determines which records matter and who on the home side should be copied.
Ask your home clinician to state the question in their own words if possible. A question written by the treating team carries more weight than a patient's paraphrase, and it reduces the risk that the Chinese team answers a different question than the one your home team intended. If the home team will not write directly, ask them to confirm your written summary before you send it.
Identify every document so both sides can refer to the same item
When two clinical teams in different countries discuss a case, ambiguity about which report is being discussed wastes time and can lead to contradictory replies. Give every document a stable identifier: the issuing laboratory or hospital, the report date, the patient name as it appears, the specimen or accession number if one exists, and the page count. Use the same identifier in every email and in the covering summary.
Existing report types are examples to confirm with the receiving team, not a universal mandatory list. Depending on the case, the home side may hold a clinical summary or referral letter, a prior exome or genome report, a variant list, a pedigree or family history summary, imaging or pathology reports, and a medication or treatment summary. The Chinese team may ask for some, all, or none of these. Ask them to specify in writing what they need for the particular request.
If a document exists only in a language other than English, ask the home team whether a certified or working translation is available and whether the receiving team requires it. Do not assume that a translation prepared for one purpose will be accepted for another. Confirm the language and format requirement with the receiving team before you pay for translation.
Keep a single index document that lists each item, its identifier, its language, its format, and who holds the original. This index becomes the reference point when either side asks 'which report do you mean?' It also makes it obvious if a document is missing rather than merely unmentioned.
Name one responsible person on each side
Cross-border exchanges stall when responsibility is shared informally. Agree on one named contact at the home clinic and one named contact at the Chinese provider. Each should be authorised to send records, receive replies, and ask clarifying questions without waiting for a committee. Record their role, not just their name: for example, 'home clinical geneticist's coordinator' and 'receiving laboratory international patient contact'.
Ask each contact to confirm in writing what they will do and by when. A short email is enough: 'I will send the indexed records to this address by this date' and 'We will confirm receipt and state whether the request is within scope.' This is administrative planning, not a clinical commitment. The receiving team decides whether the request is suitable for its service.
If a coordinator or interpretation service is involved, clarify that this person is not making clinical decisions. Their role is to move documents, confirm receipt, and relay questions accurately. The treating clinicians on both sides remain responsible for clinical judgement. Ask the Chinese provider to state in writing who will review the material and what that review can and cannot establish.
Agree the written scope before any review begins
Before records are sent, ask the Chinese provider for a written statement of what the review includes and what it does not. Useful scope questions include: which documents will be reviewed; whether raw sequencing data will be reanalysed or only the existing report read; whether a written opinion will be issued; whether a follow-up discussion is included; and what the provider needs from the home team to complete the review.
Ask specifically about what is included, excluded, or still undecided in any quotation. Do not assume that a component is charged separately, and do not assume it is included. The provider's own written quote is the reference point. If a term is unclear, ask for it in writing rather than relying on a verbal explanation.
A preliminary reply is not the same as a completed review. If the Chinese team responds that the request is 'possible' or 'under consideration', ask what remains to be confirmed and who will confirm it. A preliminary reply changes your decision only if it tells you whether the request is within scope and what the next step is. If it does not, ask again.
Handle the handover of raw data and reports deliberately
Whole exome data files are large, and transfer method matters. Ask the Chinese provider which transfer method it accepts, what file format it requires, and whether it needs the raw data or only the interpreted report. Ask the home laboratory whether it can release the raw data directly and what consent or authorisation it requires. These are administrative questions for the two laboratories, not clinical decisions.
Confirm receipt explicitly. A sent file is not a received file. Ask the receiving contact to confirm the file name, size, and date received, and to state whether the file is readable. If a transfer fails, the home laboratory may need to resend or use a different method. Build this confirmation step into the exchange rather than assuming success.
Keep the home team informed of what has been sent. If the Chinese team issues a report or opinion, send it back to the named home contact with the same document identifiers used earlier. Ask the home team to confirm receipt and to state whether they need anything further. This closes the loop and prevents the home team from learning about the review only after the patient returns.
Prepare the questions you will ask before and after the exchange
Write your questions down before contact so that you can check whether each one has been answered. Useful administrative questions for the Chinese provider include: what records do you need for this request; who will review them; what will the written output contain; what is included in the quotation; what remains to be confirmed; and what is the next step if the request is accepted. Useful questions for the home team include: can you release the raw data; can you write or confirm the clinical question; who is the named contact; and will you review any report the Chinese team issues.
Do not treat a records-based review as final eligibility, hospital acceptance, or a treatment decision. The receiving hospital and its clinicians decide suitability. A review can clarify whether a request is within scope and what information is missing, but it does not establish that a test, appointment, or treatment will proceed.
If your home clinician gives you a different recommendation after seeing the Chinese team's reply, ask what changed and what they now recommend. A changed recommendation is useful information, not a failure of the exchange. Record the reason so that the next communication starts from the current position rather than repeating the earlier one.
ChinaSpecialistCare can help organise records, clarify the written request, and request a specialist appointment for a whole exome sequencing review. An initial enquiry is free and does not require buying a proxy consultation. The hospital decides suitability. You can start with a short summary through the enquiry form, email, or WhatsApp, and share fuller records after first contact.
Sources & scope of this guide
References and official service information relevant to this guide.
This is general planning information and has not been individually reviewed by a doctor. Medical decisions and personal treatment advice come from your treating clinicians.