Better technology vital for incorporating family histories

A group of male Vietnam-era war veterans were found to have lower rates of diabetes than a group of non-veterans, based on family histories they submitted through an electronic questionnaire.

Researchers from the University of West Florida and the Robert E. Mitchell Center for Prisoner of War Studies in Pensacola, Fla., developed the questionnaire to illustrate how family histories, including first-degree relatives, could be used for research and incorporated into clinical-decision tools.

Stage 2 Meaningful Use, scheduled to go into effect in 2014, includes a menu objective of having family history recorded as structured data. Having that information in the EHR can help remind clinicians of important testing and risk assessments for diseases with a generic component, but so far technology is lacking for incorporating that information in a computable form, note the authors in a paper at Perspectives on Health Information Management.

"Unfortunately, no standard, simple generic [family health questionnaire] is available for common use in primary care, with or without an EHR system," the authors write.

Their study sought to determine whether nondiabetic participants with a positive family history of diabetes differed from nondiabetic participants with no family history of diabetes.

The veterans in the study did not match a cross-section of the U.S. population, the authors concluded, largely because the group was of a higher socioeconomic status than the norm--they were white, college-educated men.

If the family history measure is adopted, clinicians and hospitals must record family histories for first-degree relatives as structured data for more than 20 percent of all patients. This will require data standards such as SNOMED-CT, with patient portals the most likely option for patients to upload and edit their family histories.

Family history was a key factor that 76 percent of physicians wanted to appear in EHR problem lists, according to a study published at BMC Medical Informatics and Decision Making.

A Frost & Sullivan analysis recently predicted that the market for patient portal technology will grow significantly over the next five years to $898.4 million in 2017, with doctors and hospitals moving to a next generation of the technology.

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