Back to Search
Start Over
Can Automated Alerts in the Electronic Health Record Encourage Referrals for Genetic Counseling and Testing Among Patients at High Risk for Hereditary Cancer Syndromes?
- Source :
- JCO Oncology Practice; Jul2022, Vol. 18 Issue 7, pe1219-e1224, 6p
- Publication Year :
- 2022
-
Abstract
- PURPOSE Up to 10% of cancers may be associated with an inherited mutation that increases cancer risk. National guidelines emphasize referral for genetic counseling and testing for patients whose personal and/or family history increases their risk of having a hereditary cancer syndrome. METHODS To increase appropriate referrals for cancer genetic counseling and testing, we piloted an automated alert known as a Best Practice Advisory (BPA) in the electronic health record, Epic, to notify oncology providers when a patient had a personal and/or family history that merited referral to cancer genetics. Epic could not gather the complex clinical data needed for the referral decision automatically, necessitating staff completion of a questionnaire. After educating providers, the BPA was implemented with resources to support its use. RESULTS Initial interaction with the alert was high but rapidly dwindled, resulting in questionnaire completion in 7.2% of more than 32,000 encounters and 14.9% of patients over 9 months. However, cancer genetics referrals increased 95.9% during the pilot (P,.0001), with 18.5% placed through the BPA and the rest from a non-BPA mechanism. Semistructured interviews with key stakeholders revealed not only general acceptance of the BPA concept but also barriers to completion, such as pressure to room patients quickly in the face of competing BPAs and lack of buy-in from some providers. CONCLUSION These results suggest that provider engagement and BPA fatigue are significant obstacles to acceptance of a new automated alert. Despite interest in a tool for cancer genetics, the demand on clinical time for this complex BPA was poorly tolerated. [ABSTRACT FROM AUTHOR]
- Subjects :
- PROFESSIONAL practice
PILOT projects
RESEARCH methodology
GENETIC disorders
EVIDENCE-based medicine
INTERVIEWING
CANCER patients
MEDICAL referrals
QUESTIONNAIRES
SOUND recordings
RESEARCH funding
GENETIC counseling
ELECTRONIC health records
CONTENT analysis
THEMATIC analysis
HEREDITARY cancer syndromes
DISEASE risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 26881527
- Volume :
- 18
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- JCO Oncology Practice
- Publication Type :
- Academic Journal
- Accession number :
- 157968859
- Full Text :
- https://doi.org/10.1200/OP.21.00641