ABSTRACT
BACKGROUND
There is growing interest in developing systems to overcome barriers for acquiring and interpreting family health histories in primary care.
OBJECTIVE
To examine the capacity of three different electronic portals to collect family history from patients and deposit valid data in an electronic health record (EHR).
DESIGN
Pilot trial.
PARTICIPANTS, INTERVENTION
Patients were enrolled from four primary care practices and were asked to collect family health history before a physical exam using either telephone-based interactive voice response (IVR) technology, a secure internet portal, or a waiting room laptop computer, with portal assigned by practice. Intervention practices were compared to a “usual care” practice, where there was no standard workflow to document family history (663 participants in the three intervention arms were compared to 296 participants from the control practice).
MAIN MEASURES
New documentation of any family history in a coded EHR field within 30 days of the visit. Secondary outcomes included participation rates and validity.
KEY RESULTS
Demographics varied by clinic. Documentation of new family history data was significantly higher, but modest, in each of the three intervention clinics (7.5 % for IVR clinic, 20.3 % for laptop clinic, and 23.1 % for patient portal clinic) versus the control clinic (1.7 %). Patient-entered data on common conditions in first degree relatives was confirmed as valid by a genetic counselor for the majority of cases (ranging from 64 to 82 % in the different arms).
CONCLUSIONS
Within primary care practices, valid patient entered family health history data can be obtained electronically at higher rates than a standard of care that depends on provider-entered data. Further research is needed to determine how best to match different portals to individual patient preference, how the tools can best be integrated with provider workflow, and to assess how they impact the use of screening and prevention.
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Acknowledgements
This project was supported by Award Number RC1HG005331 using American Recovery and Reinvestment Act (ARRA) funds from the National Human Genome Research Institute, and by Award Number U54CA163307 from the National Cancer Institute.
Conflict of Interest
The authors declare that they do not have a conflict of interest.
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Murray, M.F., Giovanni, M.A., Klinger, E. et al. Comparing Electronic Health Record Portals to Obtain Patient-Entered Family Health History in Primary Care. J GEN INTERN MED 28, 1558–1564 (2013). https://doi.org/10.1007/s11606-013-2442-0
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DOI: https://doi.org/10.1007/s11606-013-2442-0