Web-based tools, EHRs help physicians identify genetic risks
Documenting family history should be more than a hobby for amateur genealogists, according to researchers from Brigham and Women’s Hospital in Boston, Massachusetts. Health information about parents, aunts and uncles, and siblings, such as diagnoses of cancer, heart disease, and other genetic conditions, can help patients receive screenings, genetic testing, and preventative care if the data is imported into a patient’s EHR.
Researchers asked 996 patients to fill out a web-based risk appraisal form using a laptop before a routine doctor’s appointment, containing questions about diet, physical activity, smoking, and family history of heart disease, diabetes, stroke, and cancers. The information was sent to their physicians, and the researchers calculated how many physicians accepted the data into the EHR and used it to devise a treatment plan.
“We found that 10.6 percent of patients who used the tool had new information on family history of cancer entered in the EHR within 30 days after their visit, compared to less than one percent of control patients,” explained Dr. Heather Baer, lead author of the study. “This type of risk assessment tool may be useful for collecting information on family history and lifestyle factors and may also help increase communication between physicians and patients about their risk.”
While most of the patients had no significant risk of cancer in their family history, nearly 13% had a first-degree relative with a cancer diagnosis. Of those who had no elevated risk, only 40% had heard about genetic testing for cancer. Five percent of those patients had discussed the issue with their primary care physician, and 37% of those patients were advised to schedule a genetic test. Half of those patients with a close family member suffering from cancer had heard about testing. However, a similarly small percentage had discussed it with a physician. The results “suggest that information about genetic testing is not reaching many at higher risk of inherited cancer.”
By importing the patient-provided data into an EHR, physicians have a more complete view of the patient’s medical history, and can make more informed decisions about their care. With Stage 3 Meaningful Use placing a premium on this type of patient-provided data, the study suggests that simple questionnaires provided before an office visit can collect the information in a structured, sensible way. The Surgeon General’s office recently released an update of a similar initiative, designed to create an online family tree highlighting health risks that could help physicians provide more comprehensive care.
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