记录我们的基因:利益相关者对网络电子病历中基因检测结果的看法。

Megan Prictor, Maria Rychkova
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摘要

背景:在澳大利亚,国家政策优先考虑临床遗传数据与网络电子病历(EMRs)的整合,以加强护理和临床决策的协调。目的:调查患者、家属、患者维权人士和临床医生在使用网络化电子病历获取临床遗传信息方面的需求、隐私期望和担忧。方法:采用有目的抽样方法,招募27名参与者进行半结构化定性访谈,主要通过Zoom进行访谈。采访是录音和录像,并对外转录。然后在NVivo中使用归纳主题方法对访谈记录进行编码和分析。结果:主题分析揭示了参与者对遗传信息获取和处理的不同偏好,确定了五个核心主题:获取和控制程度;基因专业人员作为信息守门人的核心作用;家庭影响的复杂性;外部风险;法律、治理和政策;所有这些强烈的主题都出现在众多参与者身上。结论:该项目对澳大利亚主要利益攸关方关于将健康相关基因检测结果纳入联网电子病历的观点、需求和关切产生了前所未有的重要见解。意义:这些发现为澳大利亚急需的法律改革和基因检测结果的决策提供了关键的参考点。
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Recording our genes: Stakeholder views on genetic test results in networked electronic medical records.

Background: In Australia, national policy prioritises the integration of clinical genetic data with networked electronic medical records (EMRs) for enhanced coordination of care and clinical decision-making. Objective: To examine the needs, privacy expectations and concerns of patients, family members, patient advocates and clinicians in relation to the use of networked EMRs for clinical genetic information. Method: Purposive sampling was used to recruit 27 participants for a semi-structured qualitative interview, primarily over Zoom. The interviews were audio and video-recorded and externally transcribed. Interview transcripts were then coded and analysed in NVivo, using an inductive thematic approach. Results: Thematic analysis revealed diverse preferences regarding genetic information access and handling across participants, with five core themes being identified: degree of access and control; central role of genetic professionals as information gatekeepers; complexities of familial implications; external risks; and law, governance and policy; all strong themes that emerged across numerous participants. Conclusion: This project yielded unprecedented and significant insights into the views, needs and concerns of key stakeholders in Australia regarding the inclusion of health-related genetic test results in networked EMRs. Implications: These findings provide a critical reference point for much-needed law reform and policy-making around genetic test results in Australia.

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