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BMC Primary Care
Published in: BMC Primary Care 1/2013

Open Access 01-12-2013 | Research article

Patient and primary care provider experience using a family health history collection, risk stratification, and clinical decision support tool: a type 2 hybrid controlled implementation-effectiveness trial

Authors: R Ryanne Wu, Lori A Orlando, Tiffany L Himmel, Adam H Buchanan, Karen P Powell, Elizabeth R Hauser, Astrid B Agbaje, Vincent C Henrich, Geoffrey S Ginsburg

Published in: BMC Primary Care | Issue 1/2013

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Abstract

Background

Family health history (FHH) is the single strongest predictor of disease risk and yet is significantly underutilized in primary care. We developed a patient facing FHH collection tool, MeTree©, that uses risk stratification to generate clinical decision support for breast cancer, colorectal cancer, ovarian cancer, hereditary cancer syndromes, and thrombosis. Here we present data on the experience of patients and providers after integration of MeTree© into 2 primary care practices.

Methods

This was a Type 2 hybrid controlled implementation-effectiveness study in 3 community-based primary care clinics in Greensboro, NC. All non-adopted adult English speaking patients with upcoming routine appointments were invited. Patients were recruited from December 2009 to the present and followed for one year. Ease of integration of MeTree© into clinical practice at the two intervention clinics was evaluated through patient surveys after their appointment and at 3 months post-visit, and physician surveys 3 months after tool integration.

Results

Total enrollment =1,184. Average time to complete MeTree© = 27 minutes. Patients found MeTree©: easy to use (93%), easy to understand (97%), useful (98%), raised awareness of disease risk (85%), and changed how they think about their health (86%). Of the 26% (N = 311) asking for assistance to complete the tool, age (65 sd 9.4 vs. 57 sd 11.8, p-value < 0.00) and large pedigree size (24.4 sd 9.81 vs. 22.2 sd 8.30, p-value < 0.00) were the only significant factors; 77% of those requiring assistance were over the age of 60. Providers (N = 14) found MeTree©: improved their practice (86%), improved their understanding of FHH (64%), made practice easier (79%), and worthy of recommending to their peers (93%).

Conclusions

Our study shows that MeTree© has broad acceptance and support from both patients and providers and can be implemented without disruption to workflow.
Appendix
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Metadata
Title
Patient and primary care provider experience using a family health history collection, risk stratification, and clinical decision support tool: a type 2 hybrid controlled implementation-effectiveness trial
Authors
R Ryanne Wu
Lori A Orlando
Tiffany L Himmel
Adam H Buchanan
Karen P Powell
Elizabeth R Hauser
Astrid B Agbaje
Vincent C Henrich
Geoffrey S Ginsburg
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2013
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-14-111

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