Development and validation of a primary care-based family health history and decision support program (MeTree).

Lori A. Orlando, Adam H. Buchanan, Susan E. Hahn, Carol A. Christianson, Karen P. Powell, Celette Sugg Skinner, Blair Chesnut, Colette Blach, Barbara Due, Geoffrey S. Ginsburg, Vincent C. Henrich

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Family health history is a strong predictor of disease risk. To reduce the morbidity and mortality of many chronic diseases, risk-stratified evidence-based guidelines strongly encourage the collection and synthesis of family health history to guide selection of primary prevention strategies. However, the collection and synthesis of such information is not well integrated into clinical practice. To address barriers to collection and use of family health histories, the Genomedical Connection developed and validated MeTree, a Web-based, patient-facing family health history collection and clinical decision support tool. MeTree is designed for integration into primary care practices as part of the genomic medicine model for primary care. We describe the guiding principles, operational characteristics, algorithm development, and coding used to develop MeTree. Validation was performed through stakeholder cognitive interviewing, a genetic counseling pilot program, and clinical practice pilot programs in 2 community-based primary care clinics. Stakeholder feedback resulted in changes to MeTree's interface and changes to the phrasing of clinical decision support documents. The pilot studies resulted in the identification and correction of coding errors and the reformatting of clinical decision support documents. MeTree's strengths in comparison with other tools are its seamless integration into clinical practice and its provision of action-oriented recommendations guided by providers' needs. The tool was validated in a small cohort. CONcLUSION: MeTree can be integrated into primary care practices to help providers collect and synthesize family health history information from patients with the goal of improving adherence to risk-stratified evidence-based guidelines.

Original languageEnglish (US)
Pages (from-to)287-296
Number of pages10
JournalNorth Carolina Medical Journal
Volume74
Issue number4
StatePublished - Jul 2013

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Medical History Taking
Clinical Decision Support Systems
Primary Health Care
Guidelines
Genetic Counseling
Primary Prevention
Chronic Disease
Medicine
Morbidity
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Orlando, L. A., Buchanan, A. H., Hahn, S. E., Christianson, C. A., Powell, K. P., Skinner, C. S., ... Henrich, V. C. (2013). Development and validation of a primary care-based family health history and decision support program (MeTree). North Carolina Medical Journal, 74(4), 287-296.

Development and validation of a primary care-based family health history and decision support program (MeTree). / Orlando, Lori A.; Buchanan, Adam H.; Hahn, Susan E.; Christianson, Carol A.; Powell, Karen P.; Skinner, Celette Sugg; Chesnut, Blair; Blach, Colette; Due, Barbara; Ginsburg, Geoffrey S.; Henrich, Vincent C.

In: North Carolina Medical Journal, Vol. 74, No. 4, 07.2013, p. 287-296.

Research output: Contribution to journalArticle

Orlando, LA, Buchanan, AH, Hahn, SE, Christianson, CA, Powell, KP, Skinner, CS, Chesnut, B, Blach, C, Due, B, Ginsburg, GS & Henrich, VC 2013, 'Development and validation of a primary care-based family health history and decision support program (MeTree).', North Carolina Medical Journal, vol. 74, no. 4, pp. 287-296.
Orlando, Lori A. ; Buchanan, Adam H. ; Hahn, Susan E. ; Christianson, Carol A. ; Powell, Karen P. ; Skinner, Celette Sugg ; Chesnut, Blair ; Blach, Colette ; Due, Barbara ; Ginsburg, Geoffrey S. ; Henrich, Vincent C. / Development and validation of a primary care-based family health history and decision support program (MeTree). In: North Carolina Medical Journal. 2013 ; Vol. 74, No. 4. pp. 287-296.
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