Electronic health record interventions at the point of care improve documentation of care processes and decrease orders for genetic tests commonly ordered by nongeneticists. Scheuner Maren T et al. Genetics in medicine : official journal of the American College of Medical Genetics 2016 Jun

Electronic health record interventions at the point of care improve documentation of care processes and decrease orders for genetic tests commonly ... - PubMed - NCBI

Genet Med. 2016 Jun 30. doi: 10.1038/gim.2016.73. [Epub ahead of print]

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

Scheuner MT1,2, Peredo J1, Tangney K1, Schoeff D1, Sale T1, Lubick-Goldzweig C1,2, Hamilton A1,3, Hilborne L4,5, Lee M1, Mittman B1, Yano EM1,6, Lubin IM7.

Author information

Abstract

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.Genet Med advance online publication 30 June 2016Genetics in Medicine (2016); doi:10.1038/gim.2016.73.

PMID:

 

27362912

 

DOI:

 

10.1038/gim.2016.73

[PubMed - as supplied by publisher]

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Relevant Resources

• Genetics and Genomics Competencies Center (G2C2)
• NIH Genetic Testing Registry
• NIH MedGen Database
• Online Mendelian Inheritance in Man (OMIM)
• PharmGKB