The Use of a Family History Risk Assessment Tool within a Community Health Care System: Views of Primary Care Providers
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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).
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