EMR documentation of physician-patient communication following genomic counseling for actionable complex disease and pharmacogenomic results.

TitleEMR documentation of physician-patient communication following genomic counseling for actionable complex disease and pharmacogenomic results.
Publication TypeJournal Article
Year of Publication2017
AuthorsSweet, K., Sturm, A. C., Schmidlen, T., Hovick, S., Peng, J., Manickam, K., Salikhova, A., McElroy, J., Scheinfeldt, L., Toland, A. E., Roberts, J. S., & Christman, M.
JournalClinical genetics
Volume91
Issue4
Pagination545-556
Date Published2017 Apr
ISSN1399-0004
Abstract

Genomic risk information for potentially actionable complex diseases and pharmacogenomics communicated through genomic counseling (GC) may motivate physicians and patients to take preventive actions. The Ohio State University-Coriell Personalized Medicine Collaborative is a randomized trial to measure the effects of in-person GC on chronic disease patients provided with multiplex results. Nine personalized genomic risk reports were provided to patients through a web portal, and to physicians via electronic medical record (EMR). Active arm participants (98, 39% female) received GC within 1 month of report viewing; control arm subjects (101, 54% female) could access counseling 3-months post-report viewing. We examined whether GC affected documentation of physician-patient communication by reviewing the first clinical note following the patient's GC visit or report upload to the EMR. Multivariable logistic regression modeling estimated the independent effect of GC on physician-patient communication, as intention to treat (ITT) and per protocol (PP), adjusted for physician educational intervention. Counselees in the active arm had more physician-patient communications than control subjects [ITT, odds ratio (OR): 3.76 (95% confidence interval (CI): 1.38-10.22, p < 0.0094); PP, OR: 5.53 (95% CI: 2.20-13.90, p = 0.0017). In conclusion, GC appreciably affected physician-patient communication following receipt of potentially actionable genomic risk information.

DOI10.1111/cge.12820
Alternate JournalClin. Genet.