The Use of a Family History Risk Assessment Tool within a Community Health Care System: Views of Primary Care Providers
- 625 Downloads
Primary care providers (PCPs) offered input regarding the incorporation of a family health history (FHH) risk assessment tool into a community health care system (CHCS). Sixteen PCPs participated in one of three focus groups. Perceived impediments included the lack of standard screening guidelines, effective screening tests, genetic counseling resources, and services for high-risk patients. The PCPs were concerned about their level of expertise, the cost of preventive health care, and genetic discrimination. They also were concerned about the use of a FHH tool by oncologists within the CHCS because of communication gaps between oncologists and PCPs, lack of clarity regarding follow-up and legal liability, and reimbursement issues. To integrate a FHH tool into a CHCS, PCPs will need consultation and referral services, evidence-based recommendations, and “just-in-time” educational resources. Oncologists who use the tool will need to develop a streamlined communication system with PCPs, establish clearly defined roles, and ensure patient follow-up.
KeywordsFamily history Primary care providers Community health care system Personalized medicine
This work was performed under the auspices of *The Genomedical Connection: Margaret Pericak-Vance, Ph.D., (PI), Jeffery Vance, Ph.D., M.D, Susan Blanton, Ph.D., Susan Hahn, M.S., William Scott, Ph.D., (Miami Institute of Human Genetics, University of Miami, FL), Elizabeth Hauser, Ph.D., Mark Donahue, M.D., Adam Buchanan, M.S. MPH., (Center of Human Genetics and Department of Medicine, Duke University); Vincent Henrich, Ph.D., Karen Powell, M.S., Carol Christianson, M.S., Debra Wallace, Ph.D., Susan Letvak, Ph.D., (The Center for Biotechnology, Genomics and Health Research, The University of North Carolina at Greensboro); Pamela Lietz, MBA, and Astrid Agbaje, MA (Cone Health). Funding for this project was provided by the U. S. Department of the Army (W81XWH-05-1-0383).
- Carroll, J. C., Rideout, A. L., Wilson, B. J., Allanson, J., Blaine, S. M., Esplen, M. J., et al. (2009). Genetic education for primary care providers: improving attitudes, knowledge, and confidence. Cancer Family Physician, 55, e92–99.Google Scholar
- Cohn, W. F., Ropka, M. E., Pelletier, S. L., Barrett, J. R., Kinzie, M. B., Harrison, M. B., et al. (2010). Health Heritage©, a web-based tool for the collection and assessment of family history: initial user experience and analytic validity. Public Health Genomics, 13, 477–491.PubMedCrossRefGoogle Scholar
- Core Competencies for all health care professionals. (2007). National Coalition for Health Professional Education in Genetics, available at: http://www.nchpeg.org/index.php?option=com_content&view=article&id=94&Itemid=84, accessed 23 October 2010.
- Khoury, M. J., Burke, W., & Thomson, E. J. (2000). Genetics and public health in the 21st century: Using genetic information to improve health and prevent disease. New York: Oxford University Press.Google Scholar
- Krueger, R. (1994). Focus groups: A practical guide for applied research (2nd ed.). California: SAGE Publications.Google Scholar
- My family health portrait: A tool from the Surgeon General. (2010). U.S. Department of Health and Human Services, available at https://familyhistory.hhs.gov/fhh-web/home.action, accessed 7 May 2010.
- NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™). (2011). National Comprehensive Cancer Network, available at: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp, accessed 1 March 2011.
- Qureshi, N., Wilson, B., Santaguida, P., Little, J., Carroll, J., Allanson, J., et al. (2009). NIH State-of-the-Science Conference: Family History and Improving Health. Evidence Report/Technology Assessment No. 186. (Prepared by the McMaster University Evidence-based Practice Center, under Contract No. 290-2007-10060-I.) AHRQ Publication No. 09-E016. Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
- Yoon, P. W., Scheuner, M. T., Jorgensen, C., & Khoury, M. J. (2009). Developing Family Healthware, a family history screening tool to prevent common chronic diseases. Preventing Chronic Disease, 6(1), 1–11.Google Scholar