Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Mar 1;4(1):ooab014.
doi: 10.1093/jamiaopen/ooab014. eCollection 2021 Jan.

An electronic health record (EHR) log analysis shows limited clinician engagement with unsolicited genetic test results

Jordan G Nestor  1 , Alexander Fedotov  2 , David Fasel  3 , Maddalena Marasa  1   3 , Hila Milo-Rasouly  1   3 , Julia Wynn  4 , Wendy K Chung  5 , Ali Gharavi  1   3 , George Hripcsak  6 , Suzanne Bakken  6 , Soumitra Sengupta  6 , Chunhua Weng  6
Affiliations
Case Reports

An electronic health record (EHR) log analysis shows limited clinician engagement with unsolicited genetic test results

Jordan G Nestor et al. JAMIA Open. .

Abstract

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.

Keywords: clinical engagement with genomic results; electronic health records; log analysis.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Study flowchart.
See this image and copyright information in PMC

References

    1. Green RC, Goddard KAB, Jarvik GP, et al. Clinical sequencing exploratory research consortium: accelerating evidence-based practice of genomic medicine. Am J Hum Genet 2016; 98 (6): 1051–66. - PMC - PubMed
    1. Weitzel KW, Alexander M, Bernhardt BA, et al. The IGNITE network: a model for genomic medicine implementation and research. BMC Med Genomics 2016; 9 (1): 1. - PMC - PubMed
    1. Gottesman O, Kuivaniemi H, Tromp G, et al. The Electronic Medical Records and Genomics (eMERGE) Network: past, present, and future. Genet Med 2013; 15 (10): 761–71. - PMC - PubMed
    1. Aronson S, Babb L, Ames D, et al. Empowering genomic medicine by establishing critical sequencing result data flows: the eMERGE example. J Am Med Inform Assoc 2018; 25 (10): 1375–81. - PMC - PubMed
    1. Wu DTY, Smart N, Ciemins EL, et al. Using EHR audit trail logs to analyze clinical workflow: A case study from community-based ambulatory clinics. AMIA Annu Symp Proc 2017; 2017: 1820–7. - PMC - PubMed

Publication types

LinkOut - more resources