Genetics in Medicine – This paper describes the implementation outcomes associated with integrating a family health history–based risk assessment and clinical decision support platform within primary care clinics at four diverse healthcare systems.
Personalized Medicine – Family health history (FHH) information is well established as a basis for assessing a patient’s personal disease risk, but is underutilized for diagnosis and making medical recommendations. Epidemiological and genetic information have heightened the value of FHH to an individual’s health. This has motivated the development of new FHH collection tools and strategies for family members, but will require greater awareness and knowledge by both patients and practitioners.
Journal of Genetic Counseling – Family health history (FHH) in the context of risk assessment has been shown to positively impact risk perception and behavior change. The added value of genetic risk testing is less certain. The aim of this study was to determine the impact of Type 2 Diabetes (T2D) FHH and genetic risk counseling on behavior and its cognitive precursors.
Genetics in Medicine – Risk assessment based on the combination of personal and family health history is an effective and essential component of preventive health and is recommended by numerous medical organizations and guideline-making bodies. Examples of risk-management strategies predicated on risk assessment include breast magnetic resonance imaging (MRI), early (age <50 years) colon cancer screening, and BRCAgenetic testing.
Implementation Science – Risk assessment with a thorough family health history is recommended by numerous organizations and is now a required component of the annual physical for Medicare beneficiaries under the Affordable Care Act. However, there are several barriers to incorporating robust risk assessments into routine care. MeTree, a web-based patient-facing health risk assessment tool, was developed with the aim of overcoming these barriers.
Journal of Biomedical Informatics – In this paper, we describe and evaluate three different approaches that use machine learning to build predictive models using temporal EHR data of a patient.
Journal of Genetic Counseling – Although MeTree identified a significant proportion of patients for whom GC was recommended, persistent barriers indicate the need for improved referral processes and patient and physician education about the benefits of GC.
Journal of Genetic Counseling – Several barriers inhibit collection and use of detailed family health history (FHH) in primary care. MeTree, a computer‐based FHH intake and risk assessment tool with clinical decision support, was developed to overcome these barriers. Here, we describe the impact of MeTree on genetic counseling (GC) referrals and attendance.
Familial Cancer – Patient education improves FHH collection and subsequent risk stratification utilized in providing actionable evidence-based care recommendations for cancer risk management.
Journal of Family Medicine & Community Health –
There are several barriers to the appropriate use of Family Health History (FHH)for risk management within primary care. Among these is a lack of physician confidence in their ability to identify high risk individuals and determine guideline concordant care. In this study, we compared Primary Care Providers’ (PCP) clinical assessment of appropriate risk-management for patients to guideline based recommendations generated by an IT platform, MeTree. In addition, we compared MeTree with clinical assessments of Genetic Counselors (GC).