Web-based risk appraisal tool increases capture of family history data in electronic health records
Health Information Technology
A Web-based tool successfully collected information on family history and lifestyle factors from primary care patients that might otherwise be missed during a new patient visit or annual examination, according to a new study. The tool, Your Health Snapshot (YHS), was developed at an academic medical center in St. Louis to obtain any history of cancer among the patient’s close relatives, as well as lifestyle information that is used to estimate a patient’s risk of cancer and other chronic diseases.
The researchers adapted YHS to incorporate more detailed information on family history of cancer and to send this information to the patient’s electronic health record (EHR) for providers to view and approve. In addition, YHS produced a summary report (risk assessment) that the patient could take into the primary care appointment to discuss possible areas of elevated risk with their provider.
Of 9,647 eligible intervention patients, 10.3 percent completed Your Health Snapshot. EHR data on family history of cancer from the patients who used YHS were compared with similar data for 637 comparable control patients (matched by clinical and demographic information). Overall, 2.0 percent of all eligible intervention patients had new documentation of a positive family history of cancer entered in coded fields in the EHR within 30 days of their visit compared with 0.6 percent of all eligible controls. Of the 996 users of YHS, 106 (10.6 percent) had new family cancer history data in their EHR within 30 days of the visit, compared with 5 (0.8 percent) of 637 matched control patients. However, when samples of the YHS users and matched controls were interviewed, the researchers found no difference in the frequency with which various risk-associated topics were discussed during the clinician visit.
The findings were based on studies of patients from three implementation primary care practices and two control primary care practices from the same large academic health care network in Boston. Eligible patients had no previous data about family cancer history in coded fields in their EHR and were seen for new patient or annual checkup visits between mid-December 2010 and mid-August 2011. The study was funded in part by AHRQ (HS19789).
More details are in "Use of a Web-based risk appraisal tool for assessing family history and lifestyle factors in primary care," by Heather J. Baer, S.D., Louise I. Schneider, M.D., Graham A. Colditz, M.D., Dr.P.H., and others in the online January 31, 2013, Journal of General Internal Medicine.