View source for 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 took a tool that was developed and used in a clinical setting to collect the patients family health history data with the use of [[CDS|clinical decision support (CDS)]] 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.<ref name="Family History-Based Clinical Decision Support">Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice.
http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pmc/articles/PMC4263968/</ref>

==Methods==
Patients were invited to complete a web based MyFamily questionaire through 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 pertaining to the upcoming appointment. All patient information was saved and the clinician received a custom patient specific report through the [http://www.healthit.gov/providers-professionals/electronic-medical-records-emr Electronic Medical Record EMR].
The MyFamily report included
*Ranked risk snapshot listing the patients risk for 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.<ref name="Family History-Based Clinical Decision Support">Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice.
http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pmc/articles/PMC4263968/</ref>

==Results==
A total of 10 primary care clinicians participated in this pilot study. The clinicians addressed three major outcomes on the implementation of this tool.<ref name="Family History-Based Clinical Decision Support">Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice.
http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pmc/articles/PMC4263968/</ref>

*The impact of MyFamily on patient care
*The impact of MyFamily on the clinical encounter and workflow
*The general process of implementation

==Discussion==
The clinicians that participated in the implementation of MyFamily, a family health history collection and CDS tool viewed the system as highly usable, fitting naturally into their existing workflows and personal practice patterns. <ref name="Family History-Based Clinical Decision Support">Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice.
http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pmc/articles/PMC4263968/</ref>

==Conclusions==
The purpose of this study was to see if this tool would aid the clinical benefits which impact their workflow. The study proved that the application was usable and fitting into their workflows and practice patterns as well as improve the value and quality of the care being provided to the patient.<ref name="Family History-Based Clinical Decision Support">Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice.
http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pmc/articles/PMC4263968/</ref>

==References==
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[[Category: Reviews]]
[[Category: CDS]]