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Protocol for the "Implementation, adoption, and utility of family history in diverse care settings" study.

Publication ,  Journal Article
Wu, RR; Myers, RA; McCarty, CA; Dimmock, D; Farrell, M; Cross, D; Chinevere, TD; Ginsburg, GS; Orlando, LA; Family Health History Network,
Published in: Implement Sci
November 24, 2015

BACKGROUND: Risk assessment with a thorough family health history is recommended by numerous organizations and is now a required component of the annual physical for Medicare beneficiaries under the Affordable Care Act. However, there are several barriers to incorporating robust risk assessments into routine care. MeTree, a web-based patient-facing health risk assessment tool, was developed with the aim of overcoming these barriers. In order to better understand what factors will be instrumental for broader adoption of risk assessment programs like MeTree in clinical settings, we obtained funding to perform a type III hybrid implementation-effectiveness study in primary care clinics at five diverse healthcare systems. Here, we describe the study's protocol. METHODS/DESIGN: MeTree collects personal medical information and a three-generation family health history from patients on 98 conditions. Using algorithms built entirely from current clinical guidelines, it provides clinical decision support to providers and patients on 30 conditions. All adult patients with an upcoming well-visit appointment at one of the 20 intervention clinics are eligible to participate. Patient-oriented risk reports are provided in real time. Provider-oriented risk reports are uploaded to the electronic medical record for review at the time of the appointment. Implementation outcomes are enrollment rate of clinics, providers, and patients (enrolled vs approached) and their representativeness compared to the underlying population. Primary effectiveness outcomes are the percent of participants newly identified as being at increased risk for one of the clinical decision support conditions and the percent with appropriate risk-based screening. Secondary outcomes include percent change in those meeting goals for a healthy lifestyle (diet, exercise, and smoking). Outcomes are measured through electronic medical record data abstraction, patient surveys, and surveys/qualitative interviews of clinical staff. DISCUSSION: This study evaluates factors that are critical to successful implementation of a web-based risk assessment tool into routine clinical care in a variety of healthcare settings. The result will identify resource needs and potential barriers and solutions to implementation in each setting as well as an understanding potential effectiveness. TRIAL REGISTRATION: NCT01956773.

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Published In

Implement Sci

DOI

EISSN

1748-5908

Publication Date

November 24, 2015

Volume

10

Start / End Page

163

Location

England

Related Subject Headings

  • User-Computer Interface
  • Risk Assessment
  • Research Design
  • Primary Health Care
  • Practice Guidelines as Topic
  • Patient Education as Topic
  • Humans
  • Health Policy & Services
  • Genetic Predisposition to Disease
  • Electronic Health Records
 

Citation

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Wu, R. R., Myers, R. A., McCarty, C. A., Dimmock, D., Farrell, M., Cross, D., … Family Health History Network, . (2015). Protocol for the "Implementation, adoption, and utility of family history in diverse care settings" study. Implement Sci, 10, 163. https://doi.org/10.1186/s13012-015-0352-8
Wu, R Ryanne, Rachel A. Myers, Catherine A. McCarty, David Dimmock, Michael Farrell, Deanna Cross, Troy D. Chinevere, Geoffrey S. Ginsburg, Lori A. Orlando, and Lori A. Family Health History Network. “Protocol for the "Implementation, adoption, and utility of family history in diverse care settings" study.Implement Sci 10 (November 24, 2015): 163. https://doi.org/10.1186/s13012-015-0352-8.
Wu RR, Myers RA, McCarty CA, Dimmock D, Farrell M, Cross D, et al. Protocol for the "Implementation, adoption, and utility of family history in diverse care settings" study. Implement Sci. 2015 Nov 24;10:163.
Wu, R. Ryanne, et al. “Protocol for the "Implementation, adoption, and utility of family history in diverse care settings" study.Implement Sci, vol. 10, Nov. 2015, p. 163. Pubmed, doi:10.1186/s13012-015-0352-8.
Wu RR, Myers RA, McCarty CA, Dimmock D, Farrell M, Cross D, Chinevere TD, Ginsburg GS, Orlando LA, Family Health History Network. Protocol for the "Implementation, adoption, and utility of family history in diverse care settings" study. Implement Sci. 2015 Nov 24;10:163.
Journal cover image

Published In

Implement Sci

DOI

EISSN

1748-5908

Publication Date

November 24, 2015

Volume

10

Start / End Page

163

Location

England

Related Subject Headings

  • User-Computer Interface
  • Risk Assessment
  • Research Design
  • Primary Health Care
  • Practice Guidelines as Topic
  • Patient Education as Topic
  • Humans
  • Health Policy & Services
  • Genetic Predisposition to Disease
  • Electronic Health Records