A complete family history (FH) may identify persons at high risk for certain conditions. They can be offered genetic testing and life-saving screening and treatment. In practice, complete FH is rarely collected or entered into the electronic medical record (EMR). The Family History Screening Questionnaire is a survey patients complete to tell whether they are at increased risk of specific cancers, heart disease or diabetes. We will test a new way to record FH that includes an app to improve use of FH by family physicians and patients. The strategy includes education for patients and physicians about the importance of FH; patient completion of the FH questionnaire prior to appointments; and prompts in the EMR. We expect this to help family physicians and patients interpret FH and make the best decisions. We will assess the proportion of patients with new EMR FH information. We will explore if the strategy increases appropriate referrals for screening and genetic consultation for those at increased FH risk. We will also obtain patients' and physicians' feedback on this strategy. This new approach may improve FH information exchange between patients and physicians, encourage shared decision-making and reduce cancer deaths and chronic disease burden.
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Proportion of patients with new documentation of family history in EMR
Timeframe: 30 days post visit
Positive family history documentation
Timeframe: 30 days post visit
Proportion of patients in each study arm with new documentation of family history in EMR
Timeframe: 6 months
Proportion of patients, for each consenting clinician, with new documentation of family history in EMR
Timeframe: 1 year
Family history of breast/ovarian/colorectal/prostate cancer
Timeframe: 30 days post visit
Changes in risk-appropriate screening based on family history
Timeframe: 30 days post visit