ASHG Research Emphasizes Medical Value of Family History

Roxanna Guilford-Blake, for HealthLeaders Media , November 9, 2010

But first, clinicians need to obtain that history. "Even if we have a wonderful validation tool, if no one knows about it, it's no good," she said at the briefing.

And that was the subject of another study. "Family Health History Education to Improve Genetic Risk Assessment for Cancer" found that implementation of a comprehensive genetics education program for primary care clinicians at the Department of Veterans Affairs Greater Los Angeles Healthcare System has resulted in better cancer family history documentation, improved recognition of patients at risk for hereditary cancer, and increased referrals for genetic consultation and testing.

This education program—developed by Maren Scheuner, MD, MPH, director of the health services genomics program and clinical genetic services at VA GLA, and her colleagues—is comprised of informational (website, CME-approved lecture series), clinical (patient and provider information sheets, a family history reminder with template in the EHR), and behavioral components (practice-feedback reports regarding clinicians' use of the EHR tool).

The clinical tools developed for the EHR appear to have had the greatest impact in changing clinician behavior. In the first five months of the program's use, 568 cancer family histories were completed using the EHR's reminder and template. As a result, the genetics consultation service at the VA GLA received 47 patient referrals for risk assessment and possible genetic testing that, according to Scheuner, "very likely would not have been made without this comprehensive genetics education program."

Evaluation is still ongoing. "If we demonstrate continued success, this program may serve as a model for improving genetic risk assessment of other health conditions, and with appropriate modifications, it could also potentially be applied in other healthcare settings as well."

But at this point, she told HealthLeaders Media, the results of the research "are perhaps most relevant to health systems that have the opportunity to provide education to their clinicians."

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