Nestor Jordan G, Fedotov Alexander, Fasel David, Marasa Maddalena, Milo-Rasouly Hila, Wynn Julia, Chung Wendy K, Gharavi Ali, Hripcsak George, Bakken Suzanne, Sengupta Soumitra, Weng Chunhua
Department of Medicine, Division of Nephrology, Columbia University, New York, New York, USA.
The Irving Institute for Clinical and Translational Research, Columbia University, New York, New York, USA.
JAMIA Open. 2021 Mar 1;4(1):ooab014. doi: 10.1093/jamiaopen/ooab014. eCollection 2021 Jan.
How clinicians utilize medically actionable genomic information, displayed in the electronic health record (EHR), in medical decision-making remains unknown. Participating sites of the Electronic Medical Records and Genomics (eMERGE) Network have invested resources into EHR integration efforts to enable the display of genetic testing data across heterogeneous EHR systems. To assess clinicians' engagement with unsolicited EHR-integrated genetic test results of eMERGE participants within a large tertiary care academic medical center, we analyzed automatically generated EHR access log data. We found that clinicians viewed only 1% of all the eMERGE genetic test results integrated in the EHR. Using a cluster analysis, we also identified different user traits associated with varying degrees of engagement with the EHR-integrated genomic data. These data contribute important empirical knowledge about clinicians limited and brief engagements with unsolicited EHR-integrated genetic test results of eMERGE participants. Appreciation for user-specific roles provide additional context for why certain users were more or less engaged with the unsolicited results. This study highlights opportunities to use EHR log data as a performance metric to more precisely inform ongoing EHR-integration efforts and decisions about the allocation of informatics resources in genomic research.
临床医生如何在医疗决策中利用电子健康记录(EHR)中显示的具有医学可操作性的基因组信息,目前尚不清楚。电子病历与基因组学(eMERGE)网络的参与站点已投入资源进行EHR集成工作,以实现跨异构EHR系统显示基因检测数据。为了评估在一家大型三级医疗学术医学中心内,临床医生对eMERGE参与者未经请求的EHR集成基因检测结果的关注情况,我们分析了自动生成的EHR访问日志数据。我们发现,临床医生仅查看了EHR中集成的所有eMERGE基因检测结果的1%。通过聚类分析,我们还确定了与对EHR集成基因组数据的不同参与程度相关的不同用户特征。这些数据提供了关于临床医生对eMERGE参与者未经请求的EHR集成基因检测结果的有限且短暂关注的重要实证知识。了解用户特定角色为某些用户对未经请求的结果参与程度或多或少提供了额外背景。本研究强调了将EHR日志数据用作性能指标的机会,以便更准确地为正在进行的EHR集成工作以及基因组研究中信息学资源分配决策提供参考。