Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice

Journal of Personalized Medicine

Megan Doerr³  Emily Edelman²  Emily Gabitzsch³  Charis Eng¹ 

[1] Genomic Medicine Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA; E-Mail:;Genomics Education, the Jackson Laboratory, 600 Main Street, Bar Harbor, ME 04609-1500, USA; E-Mail:;Center for Personalized Healthcare, Medicine Institute, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH 44195, USA; E-Mails:

关键词: family health history;    clinical decision support;    implementation;    risk stratification;    barriers;    facilitators;   

DOI  :  10.3390/jpm4020115

来源: mdpi

【 摘 要 】

Family health history is a leading predictor of disease risk. Nonetheless, it is underutilized to guide care and, therefore, is ripe for health information technology intervention. To fill the family health history practice gap, Cleveland Clinic has developed a family health history collection and clinical decision support tool, MyFamily. This report describes the impact and process of implementing MyFamily into primary care, cancer survivorship and cancer genetics clinics. Ten providers participated in semi-structured interviews that were analyzed to identify opportunities for process improvement. Participants universally noted positive effects on patient care, including increases in quality, personalization of care and patient engagement. The impact on clinical workflow varied by practice setting, with differences observed in the ease of integration and the use of specific report elements. Tension between the length of the report and desired detail was appreciated. Barriers and facilitators to the process of implementation were noted, dominated by the theme of increased integration with the electronic medical record. These results fed real-time improvement cycles to reinforce clinician use. This model will be applied in future institutional efforts to integrate clinical genomic applications into practice and may be useful for other institutions considering the implementation of tools for personalizing medical management.

【 授权许可】

CC BY   
© 2014 by the authors; licensee MDPI, Basel, Switzerland.