Formative evaluation of clinician experience with integrating family history-based clinical decision support into clinical practice

Introduction

The family health history is collected when patients go into the hospital or during a clinic visit. This area is very under utilized and unsystematically collected and inconsistently applied to guide medical care. The family health history can help clinicians improve the quality and consistency of healthcare delivery by recognizing risk factors the patient may have through family relations. This article looks a tool that was developed and used in a clinical setting to collect the patients family health history data with the use of clinical decision support to help bridge the gap. The goal was to create a standardization of collecting the data and use the family health history as a guide to care planning.

Methods

Patients were invited to complete a web based MyFamily questionaire thru their portal 2 weeks in advance of a scheduled appointment. Patients were asked general health parameters and then led through constructing their family tree. then patients were asked very specific family health history questions specific to the upcoming appointment. All patient information was saved and the clinician received a custom patient specific report through the EMR. The MyFamily report included

• ranked risk snapshot listing the patients riskfor each condition assessed
• clinical considerations, rationale and potential applicable diagnosis codes
• family health history in both pedigree and list formats
• additional educational content about each condition for both clinician and patients.

The clinician reviews the report and can decide whether to accept the documents to become part of the patients EMR.