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首页> 外文期刊>Journal of Personalized Medicine >Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice
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Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice

机译：将基于家族史的临床决策支持整合到临床实践中的临床经验的形成性评估

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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.
机译：家庭健康史是疾病风险的主要预测因子。但是，它没有被充分利用来指导护理，因此，对于健康信息技术的干预已经成熟。为了填补家庭健康史实践方面的空白，克利夫兰诊所开发了家庭健康史收集和临床决策支持工具MyFamily。该报告描述了将MyFamily应用于初级保健，癌症幸存者和癌症遗传学诊所的影响和过程。十名提供者参加了半结构化访谈，对他们进行了分析，以发现改进流程的机会。与会者普遍注意到对患者护理的积极影响，包括质量提高，护理的个性化和患者参与。对临床工作流程的影响因实践设置而异，在整合的难易程度和特定报告元素的使用上观察到差异。报告长度与所需详细信息之间的紧张关系得到赞赏。指出了执行过程的障碍和促进者，其中以增加与电子病历的整合为主题。这些结果满足了实时改进周期的需要，以加强临床医生的使用。该模型将用于将来的机构工作中，以将临床基因组学应用程序整合到实践中，并且对于考虑实施个性化医疗管理工具的其他机构可能有用。

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