J. Pers. Med. 2014, 4(2), 115-136; doi:10.3390/jpm4020115
Article

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

1,2,* email, 3,4email, 1email, 2,†email and 1,†email
Received: 10 December 2013; in revised form: 1 March 2014 / Accepted: 3 March 2014 / Published: 26 March 2014
(This article belongs to the Special Issue Bringing Personalized Medicine into Clinical Practice)
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Abstract: 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.
Keywords: family health history; clinical decision support; implementation; risk stratification; barriers; facilitators
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Doerr, M.; Edelman, E.; Gabitzsch, E.; Eng, C.; Teng, K. Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice. J. Pers. Med. 2014, 4, 115-136.

AMA Style

Doerr M, Edelman E, Gabitzsch E, Eng C, Teng K. Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice. Journal of Personalized Medicine. 2014; 4(2):115-136.

Chicago/Turabian Style

Doerr, Megan; Edelman, Emily; Gabitzsch, Emily; Eng, Charis; Teng, Kathryn. 2014. "Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice." J. Pers. Med. 4, no. 2: 115-136.

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