Best pedigree software for genetic counsellors 2026

Short version. For cancer counselling, FamGenix or Progeny Clinical. For rare disease counselling, Phenotips. For NHS and public-sector counselling, TrakGene. For fast live drawing with AI assistance, Evagene. For a free sketch tool or teaching, FastFamilyTree. The right pick depends on which of three axes matters most: institutional integration, case mix (cancer vs rare disease vs reproductive), and how much of your time is spent drawing live versus dictating from notes.

We have ranked each tool by its fit to counsellor-specific work rather than by overall prestige. Where Evagene (our product) is not the best fit, we say so.

How we evaluated

• Live-consultation drawing speed. Can you keep up with a patient's family history while maintaining eye contact?
• Cascade tracking. Can you mark at-risk relatives, track who has been contacted, and generate cascade lists?
• Consent management. Does the tool support your service's consent protocol and document it?
• Patient-friendly reports. Does the output work for patients, not just for geneticists?
• Letter generation. Are templated, merge-field clinical letters supported?
• Risk calculation. Which models, and are they integrated with the drawing workflow?
• Price transparency and free tier. Can a small service afford entry without a full procurement process?

The tools, ranked by counsellor fit

1. Progeny Clinical — mature counsellor default

Progeny Clinical has been in the hands of genetic counsellors since 1996 and is deployed in 800+ genetics institutions. Letter generation is mature, cancer risk is integrated, EHR integration is well-trodden, and test ordering is built in. For many counsellors, this is the tool they trained on.

Where it struggles for counsellors: public user complaints about consanguinity UX, awkwardness when moving family members in complex pedigrees, and features that feel less intuitive beneath the polish. Rising prices over time. Pricing is not public. The test-ordering integration is tied to Ambry, which some services treat as a neutrality consideration. Price: on application. Best for: established services that want maturity, letter templates, and a known quantity. See Progeny vs Evagene.

2. FamGenix — best for cancer counsellors

FamGenix is the most credible recent entrant in cancer counselling. Launched in 2021, in use at 4 of the top 10 US cancer centres, running BOADICEA v6 + Tyrer-Cuzick v8 + Gail + Claus + QRISK3 + BayesMendel simultaneously. HIPAA and GINA compliant, regional data residency across US, Canada, UK-EU, and Australia. A free Individual tier alongside the paid Provider Portal.

Where it struggles for counsellors: oriented heavily to cancer, less strong on general rare disease, reproductive genetics, or non-cancer pedigree work. Provider Portal pricing is on application. Price: free Individual; Provider Portal on application. Best for: cancer genetic counsellors, familial cancer clinics. See FamGenix vs Evagene.

3. Phenotips — best for rare disease counselling

Phenotips is the reference platform for HPO-driven rare disease counselling. 100,000+ patient records, 500+ specialists, 60+ countries. GDPR, DSPT, HIPAA, CE+ certified. Explicitly LGBTQIA+ inclusive — a meaningful differentiator in counselling practice.

Where it struggles for counsellors: phenotype-first workflow can be overkill in cancer or reproductive counselling where case data is pedigree-centred, not phenotype-centred. $399/month Research tier with $25/user additional is on the higher end for small services, and enterprise tiers are priced on application. No public AI interpretation engine. Price: from $399/month; enterprise on application. Best for: rare disease counsellors, undiagnosed disease clinics. See Phenotips vs Evagene.

4. TrakGene — best for NHS and FHIR-native services

TrakGene is clinician-built, HL7 FHIR native, and used at NIH, NHS sites, and Geisinger across 50+ genetics services and 800+ users. Includes HPO phenotyping, CanRisk and Gail integration, an AI copilot, and ClinVar linkage. On-premise or cloud.

Where it struggles for counsellors: no free tier, no public pricing, and evaluation requires a sales cycle. The AI copilot is vendor-mediated, not BYOK. Price: on application. Best for: NHS services, FHIR-native institutions, counsellors in multi-site public-sector deployments. See TrakGene vs Evagene.

5. Evagene — best for AI-assisted counselling and live drawing

Evagene (our product) is built around live-consultation drawing and AI-assisted interpretation. Gesture drawing mode lets you build a pedigree during the conversation — continuous gestures, keyboard shortcuts, automatic symbol standardisation — rather than interrupting the flow to click through menus. BRCAPRO, MMRpro, PancPRO, plus Mendelian (AD/AR/XR) risk models run directly on the pedigree. Four report types. Analysis Templates let your service codify its house style for letters and summaries. BYOK LLM support (Anthropic Claude, OpenAI GPT) means AI interpretation goes through your own contracted model keys.

Where we struggle for counsellors: Alpha status, and we have not yet matched the cascade-tracking depth or letter-template libraries that Progeny Clinical and TrakGene have accumulated over years. If your service's workflow is heavily letter- and cascade-centric, you will see gaps today. If your workflow is drawing-centric and you are keen on AI assistance, we are the strongest current fit. Price: free Alpha via waiting list. Best for: counsellors drawing live during consultation, services adopting AI-assisted reporting.

6. FastFamilyTree — best free counsellor-built sketch tool

FastFamilyTree was built by a genetic counsellor, is NSGC 2022 compliant, free, and stores no PHI. It is excellent for: quick sketches, teaching, informal pre-appointment notes, and patient education. It is not suitable as a longitudinal clinical record.

Where it struggles for counsellors: no persistent storage, no risk models, no letter generation, no integration. Its narrowness is the point — use it alongside a clinical tool, not instead. Price: free. Best for: teaching, demos, quick sketches, patient education sessions.

7. f-tree — best iPad-based questionnaire tool

f-tree runs on Windows, macOS, iPad, and iPhone, developed with Iwate Medical University and published in BMC Medical Genetics in 2017. Its questionnaire-based auto-pedigree approach suits services that collect family history from patients before consultation. NSGC-standard compliant. Free desktop; paid features.

Where it struggles for counsellors: less internationally visible than other tools, questionnaire-first workflow is a better fit for structured intake services than for live freeform pedigree building. Price: free desktop; paid features. Best for: counsellors with iPad-based patient intake, clinics in Japan or using questionnaire-first workflows.

Comparison matrix

Which to choose if...

• You are a cancer counsellor at a large US centre: FamGenix. The model breadth is genuinely unmatched, and the track record is there.
• You are an NHS or public-sector counsellor: TrakGene. FHIR-native, existing NHS footprint.
• You work mostly on rare disease with HPO: Phenotips. Phenotype-first is the right shape.
• You want to draw live during consultations and have AI help with reports: Evagene. Gesture drawing and BYOK AI are uniquely aligned with this workflow.
• You want the maturity and letter-template library of a long-established product: Progeny Clinical. If your budget and procurement fit, this is the safest choice.
• You need a free tool for teaching or quick sketches: FastFamilyTree.
• Your clinic uses iPads for patient intake: f-tree's questionnaire-first workflow fits.
• You are on a budget and want a clinical-credible free option: Progeny Cloud.

Frequently asked questions

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