title: Do physicians take action on high risk family history information provided by patients outside of a clinic visit?
abstract: Clinically relevant family history information is frequently missing or not readily available in electronic health records. Improving the availability of family history information is important for optimum care of many patients. Family history information on five conditions was collected in a survey from 163 primary care patients. Overall, 53% of patients had no family history information in the electronic health record (EHR) either on the patient's problem list or within a templated family history note. New information provided by patients resulted in an increase in the patient's risk level for 32% of patients with a positive family history of breast cancer, 40% for coronary artery disease, 50% for colon cancer, 74% for diabetes, and 95% each for osteoporosis and glaucoma. Informing physicians of new family history information outside of a clinic visit through an electronic clinical message and note in the EHR was not sufficient to achieve recommended follow-up care. Better tools need to be developed to facilitate the collection of family history information and to support clinical decision-making and action.
authors.affiliation: Clinical and Quality Analysis, Information Systems, Partners HealthCare System, Wellesley, MA 02481, USA. lavolk@partners.org
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Volk
authors.forename: Maria
authors.initials: M
authors.lastname: Staroselsky
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Newmark
authors.forename: Hannah
authors.initials: H
authors.lastname: Pham
authors.forename: Alexis
authors.initials: A
authors.lastname: Tumolo
authors.forename: Deborah H
authors.initials: DH
authors.lastname: Williams
authors.forename: Ruslana
authors.initials: R
authors.lastname: Tsurikova
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Schnipper
authors.forename: Jonathan
authors.initials: J
authors.lastname: Wald
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
mesh_terms: D000553:Ambulatory Care; D003625:Data Collection; D003657:Decision Making; D005192:Family Health; D020022:Genetic Predisposition to Disease; D006801:Humans; D008487:Medical History Taking / Q000379:methods; D016347:Medical Records Systems, Computerized; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment