Pre-visit questionnaire with EHR integration improves family history documentation and supports prevention and referrals in primary care

An innovative strategy for collecting family health history: an effectiveness-implementation trial in primary care clinics

2025-09-22

(Press-News.org) Original Research

Pre-Visit Questionnaire With EHR Integration Improves Family History Documentation and Supports Prevention and Referrals in Primary Care

Background and Goal: This study evaluated whether a pre-visit, patient-completed family history questionnaire that automatically uploads to the electronic health record (EHR) and triggers a same-day notification for family physicians improves family history documentation and subsequent conversations.

Study Approach: Researchers ran a six-month, matched hybrid effectiveness–implementation study in three primary care practices affiliated with the University of Toronto Practice-based Research Network (UTOPIAN). Intervention-group family physicians and patients received brief education on the importance of family history. Usual care served as the control. For fair comparison, intervention physicians and patients were matched to similar controls. The primary measure was any new or updated family history entry within 30 days of the visit; secondary measures included disease-specific entries, reported actions (screening, referrals, counseling), and patient and clinician feedback.

Main Results: Fifteen family physicians and 576 patients in the intervention group were matched with 15 family physicians and 2,203 patients in the control group.

Within 30 days of the visit, new family history was documented in the EHR by their family physician for 16.1% of intervention patients and 0.2% control patients.

Within 30 days of the visit, 7.8% of intervention patients and 0.1% of control patients had documentation of at least one of the following cancers: breast, ovarian, colorectal, prostate, or melanoma.

The majority (72%) of intervention patients who attended their appointment indicated discussing family history with their family physician at the visit.

Intervention patients reported receiving screening recommendations (24.5%), lifestyle advice (7.8%), referrals to non-genetics specialists (7.5%), and genetics referrals (about 2%).

Why It Matters: Better documentation of family history can support more personalized prevention and referrals when needed.

Permanent link: An Innovative Strategy for Collecting Family Health History: An Effectiveness-Implementation Trial in Primary Care Clinics

June C. Carroll, MD, CCFP, FCFP, et al

Mount Sinai Hospital, Sinai Health, Granovsky Gluskin Family Medicine Centre, Toronto, Ontario, Canada

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