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Primary care clinicians may get more details about their patients’ health risks if electronic health records (EHRs) prompt patients to log details before a visit, according to new findings published in Annals of Family Medicine.

The approach not only increased the amount of family history documented for those who received prompts before an appointment but also led to more genetic testing and screening orders.

Clinicians often do not have have time to ask for family history due to competing priorities in the limited window of an office visit, said June C. Carroll, MD, lead author of the study and professor in the Department of Family and Community Medicine at Mount Sinai Hospital at the University of Toronto in Toronto, Ontario, Canada.

Patients who log family history “episodically, whenever they have a chance, didn’t do as well as the people who had a systematic way of doing it,” Carroll told Medscape Medical News.

Carroll and her colleagues provided education on the importance of family history to patients and clinicians and created a screening questionnaire and clinician alerts integrated into the EHR.

More than 575 patients were part of the intervention group, and 2203 received usual care. Those in the intervention group could fill out the family history questionnaire ahead of their appointment, making this information available for physicians in the EHR. The physicians then recorded what could be important and tied to a patient’s current health status.

At baseline, 81.6% of patients receiving intervention and 86.4% of control patients had some family history recorded in their charts.

Within 30 days following a clinic visit, 16.1% of patients receiving intervention had new family history data logged in the EHR compared to 0.2% of those in the control group (adjusted odds ratio, 94.2; 95% CI, 36.8-240.8, P < .001).

Carroll said the discrepancy may be due to clinicians’ view that they already knew a patient’s family medical history.

Some patients also reported that recommendations they received during a visit were related to new family histories they provided, such as for screening tests (24.5%) and lifestyle changes (7.8%).

Physicians, meanwhile, reported that new family history drove only 3.4% of recommendations for screening or other management decisions.

More efforts should go toward engaging physicians in understanding the importance of family history, said Jay-Sheree Akambase, MD, MPH, president of the board of trustees of the American Academy of Family Physicians Foundation.

“It’s important that we not push family history to the back burner,” said Akambase, who is also a family physician at Mayo Clinic in Rochester, Minnesota. “It plays an important role, not only with risk assessment but also with management of patient care.”

Akambase said she advises her patients to deliberately ask relatives about their health and previous generation health issues.

“Sometimes it requires making some phone calls to family and actually asking these questions, especially if health related concerns aren’t openly discussed at the dinner table or in regular family conversations,” she said.

The study received funding from the Ontario Academic Health Science Centre Alternative Funding Plan Innovation Fund. 

Carroll and Akambase did not have relevant financial disclosures. One of study authors reported being an employee, cofounder, and shareholder of WELL Health Technologies Corp and OceanMD. This study involved the use of OceanMD’s patient-engagement technology. The other authors reported having no conflicts of interest. 

Kerry Dooley Young is a freelance journalist based in Washington, DC. She has covered medical research and healthcare policy for more than 20 years.