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OW STUDY The workgroup supported our suspicion that the solution we would build and offer was a small adjustment to the clinical workflow. On the other hand, the rather small adjustment to workflow would ask clinicians to consider more information than they had ever had on the genetic risk of disease based on family history. Having evidence-based information to support changes in care provided for patients based on the family history was unsettling to clinicians. We needed to take care to appreciate what seemed like small workflow adjustment to our team, may seem relatively radical to clinicians who had been blasting through family history for years (or decades) without regard to the rich phenotypic data that could be used as a proxy …show more content…

This would be the basis for a compelling and credible set of artifacts supporting how the system would be used in existing clinical workflows without being disruptive. There was no satisficing in the assessment. The points that we would make based on our observations and interpretation of the clinical workflows were simple. The steps required to use the new system fit into the existing clinical workflow The use of the system would not be disruptive The results of use brought practice into alignment with standards-of-care What wasn’t actionable before, was actionable now based on evidence Opportunity to act on the phenotypic indicators of risk for genetic disease CLINICAL DEVELOPMENT METHODOLOGY We had worked hard, very hard, to gather clinical support for the use of the new clinical decision support platform inside primary care and specialty settings. For some projects, this would have been followed immediately by a kick-off meeting and beginning of the actual design and build. In our case, the hard work had just begun. We had affirmed a key assumption in our early work with subject matter experts that understanding the published evidence used to guide effective understanding and use of clinical guidelines was overwhelming and confusing. So while we had known for sometime that our decision support tool would need to tackle these issues, it was time to finally roll-up our sleeves and produce the processes and core

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