Evaluation of a novel electronic genetic screening and clinical decision support tool in prenatal clinical settings

Emily A. Edelman, Bruce K. Lin, Teresa Doksum, Brian Drohan, Vaughn Edelson, Siobhan M. Dolan, Kevin Hughes, James O'Leary, Lisa Vasquez, Sara Copeland, Shelley L. Galvin, Nicole DeGroat, Setul Pardanani, W. Gregory Feero, Claire Adams, Renee Jones, Joan Scott

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

The Pregnancy and Health Profile (PHP) is a free prenatal genetic screening and clinical decision support (CDS) software tool for prenatal providers. PHP collects family health history (FHH) during intake and provides point-of-care risk assessment for providers and education for patients. This pilot study evaluated patient and provider responses to PHP and effects of using PHP in practice. PHP was implemented in four clinics. Surveys assessed provider confidence and knowledge and patient and provider satisfaction with PHP. Data on the implementation process were obtained through semistructured interviews with administrators. Quantitative survey data were analyzed using Chi square test, Fisher's exact test, paired t tests, and multivariate logistic regression. Open-ended survey questions and interviews were analyzed using qualitative thematic analysis. Of the 83 % (513/618) of patients that provided feedback, 97 % felt PHP was easy to use and 98 % easy to understand. Thirty percent (21/71) of participating physicians completed both pre- and post-implementation feedback surveys [13 obstetricians (OBs) and 8 family medicine physicians (FPs)]. Confidence in managing genetic risks significantly improved for OBs on 2/6 measures (p values ≤0.001) but not for FPs. Physician knowledge did not significantly change. Providers reported value in added patient engagement and reported mixed feedback about the CDS report. We identified key steps, resources, and staff support required to implement PHP in a clinical setting. To our knowledge, this study is the first to report on the integration of patient-completed, electronically captured and CDSenabled FHH software into primary prenatal practice. PHP is acceptable to patients and providers. Key to successful implementation in the future will be customization options and interoperability with electronic health records.

Original languageEnglish (US)
Pages (from-to)1233-1245
Number of pages13
JournalMaternal and child health journal
Volume18
Issue number5
DOIs
StatePublished - Jul 2014

Keywords

  • Clinical decision support
  • Family health history
  • Genetic screening
  • Personalized risk assessment
  • Prenatal care

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health

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    Edelman, E. A., Lin, B. K., Doksum, T., Drohan, B., Edelson, V., Dolan, S. M., Hughes, K., O'Leary, J., Vasquez, L., Copeland, S., Galvin, S. L., DeGroat, N., Pardanani, S., Feero, W. G., Adams, C., Jones, R., & Scott, J. (2014). Evaluation of a novel electronic genetic screening and clinical decision support tool in prenatal clinical settings. Maternal and child health journal, 18(5), 1233-1245. https://doi.org/10.1007/s10995-013-1358-y