Systematic differences in electronic health record data can negatively impact patient care

Systematic differences in electronic health record data can negatively impact patient care

Patients from historically medically underserved groups, including patients of color and Spanish-speaking patients, have less cancer family history information available. Additionally, existing health records are less comprehensive, according to a study published Oct. 4 in the Journal of the American Medical Association Network Open.

Researchers from the Huntsman Cancer Institute at the University of Utah (USA) and the Perlmutter Cancer Center at NYU Langone Health searched electronic health records in two large health systems and divided them into subgroups: race, ethnicity, language preference and gender. Researchers found differences in the availability and completeness of family history information among cancer patients from different groups.

Algorithms are being used by more and more healthcare systems to identify patients for specialty care. However, systematic differences in electronic health record data result in disparities in patient identification. Doctors are also less able to identify patients who need a change in cancer care plans based on their family history. Having less family history information in the record can have a trickle-down effect that negatively impacts patient care.”

Kim Kaphingst, ScD, Director of Cancer Communication Research, Huntsman Cancer Institute and Professor, Department of Communication, University of Utah

This research was funded by the National Cancer Institute through the Inherited Cancer Syndromes Collaborative of the Cancer Moonshot Initiative. Kaphingst is together with Dr. Meena Sigireddi of NYU Langone Health was one of the study's principal investigators. When Kaphingst and her fellow researchers realized they were identifying fewer Spanish-speaking patients than expected, questions arose.

“Using our findings, we would like to see how we can improve the collection of family history information, particularly from Spanish-speaking patients,” says Kaphingst. "What is the best way to ask questions about cancer in the family? Could we use an online tool on MyChart or use a patient navigator at appointments that captures family history? We want to ensure all patients have access to the cancer genetic services they need."

With misinformation more prevalent than ever, mistrust has become a key factor in people's unwillingness to reveal their family's medical history, Kaphingst adds. But with additional funding from the National Cancer Institute, she and her colleagues are trying to find answers to their questions.

Source:

Huntsman Cancer Institute

Reference:

Chavez-Yenter, D., et al. (2022) Association of disparities in family history and family cancer history in the electronic health record with gender, race, Hispanic or Latino ethnicity, and language preference in 2 large U.S. health systems. JAMA network opened. doi.org/10.1001/jamanetworkopen.2022.34574.

.