Electronic health record interventions at the point of care improve documentation of care processes and decrease orders for genetic tests commonly ordered by nongeneticists

Details

• Alternative Title:
  Genet Med
• Personal Author:
  Scheuner, Maren T. ; Peredo, Jane ; Tangney, Kelly ; Schoeff, Diane ; Sale, Taylor ; Lubick-Goldzweig, Caroline ; Hamilton, Alison ; Hilborne, Lee ; Lee, Martin ; Mittman, Brian ; Yano, Elizabeth M. ; Lubin, Ira M.
• Description:
  Objective
  
  To determine whether electronic health record (EHR) tools improve documentation of pre- and postanalytic care processes for genetic tests ordered by nongeneticists.
  
  Methods
  
  We conducted a nonrandomized, controlled, pre-/postintervention study of EHR point-of-care tools (informational messages and template report) for three genetic tests. Chart review assessed documentation of genetic testing processes of care, with points assigned for each documented item. Multiple linear and logistic regressions assessed factors associated with documentation.
  
  Results
  
  Preimplementation, there were no significant site differences (P > 0.05). Postimplementation, mean documentation scores increased (5.9 (2.1) vs. 5.0 (2.2); P = 0.0001) and records with clinically meaningful documentation increased (score >5: 59 vs. 47%; P = 0.02) at the intervention versus the control site. Pre- and postimplementation, a score >5 was positively associated with abnormal test results (OR = 4.0; 95% CI: 1.8–9.2) and trainee provider (OR = 2.3; 95% CI: 1.2–4.6). Postimplementation, a score >5 was also positively associated with intervention site (OR = 2.3; 95% CI: 1.1–5.1) and specialty clinic (OR = 2.0; 95% CI: 1.1–3.6). There were also significantly fewer tests ordered after implementation (264/100,000 vs. 204/100,000; P = 0.03), with no significant change at the control site (280/100,000 vs. 257/100,000; P = 0.50).
  
  Conclusions
  
  EHR point-of-care tools improved documentation of genetic testing processes and decreased utilization of genetic tests commonly ordered by nongeneticists.
  
  
• Subjects:
  Article Documentation Electronic Health Records Factor V Female Genetic Testing Hemochromatosis Protein HLA-B27 Antigen Humans Male Point-of-Care Systems

  More +
• Source:
  Genet Med. 19(1):112-120
• Pubmed ID:
  27362912
• Pubmed Central ID:
  PMC6504173
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States ; U47 CI000823/CI/NCPDCID CDC HHS/United States
• Volume:
  19
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ee02c34ca3309ecb779a54388434fca282373fcbaf18ac218a02754975b1f9d3
• Download URL:
  https://stacks.cdc.gov/view/cdc/78371/cdc_78371_DS1.pdf
• File Type:
  [PDF - 112.61 KB ]