Electronic health record interventions at the point of care improve documentation of care processes and decrease...

Area of Science:

• Medical Informatics
• Clinical Genetics
• Health Services Research

Background:

• Genetic testing is increasingly utilized, necessitating robust documentation of care processes.
• Nongeneticists often order genetic tests, highlighting the need for improved clinical support and documentation tools.

Purpose of the Study:

• To evaluate the impact of electronic health record (EHR) point-of-care tools on the documentation of pre- and postanalytic care for genetic tests.
• To assess whether EHR tools influence the utilization patterns of genetic tests ordered by non-specialists.

Main Methods:

• A nonrandomized, controlled, pre-/postintervention study design was employed.
• EHR point-of-care tools, including informational messages and a template report, were implemented for three genetic tests.
• Chart review and statistical analyses (linear and logistic regressions) were used to assess documentation quality and utilization rates.

Main Results:

• The intervention site showed significant improvements in mean documentation scores and the proportion of records with clinically meaningful documentation compared to the control site.
• Documentation scores were positively associated with abnormal test results and trainee providers, and postimplementation, with the intervention site and specialty clinics.
• A significant decrease in the utilization of genetic tests was observed at the intervention site postimplementation, but not at the control site.

Conclusions:

• EHR point-of-care tools effectively enhance the documentation of genetic testing processes.
• Implementation of EHR tools can lead to a reduction in the utilization of genetic tests ordered by nongeneticists, suggesting improved appropriateness of testing.