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

Nestor, Jordan Gabriela; Fedotov, Alexander; Fasel, David; Marasa, Maddalena; Milo-Rasouly, Hila; Wynn, Julia; Chung, Wendy K.; Gharavi, Ali G.; Hripcsak, George M.; Bakken, Suzanne R.; Sengupta, Soumitra; Weng, Chunhua

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.


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July 6, 2023