Confidential Screening for and Management of Intimate Partner Violence Risk using a Commercial Electronic Health Records System

Abstract

Intimate partner violence is, unfortunately, a common problem (25% of women) for which screening in primary care is a recommended service. In this paper, we describe modifications to a commercial EHR system (Epic) designed to support confidential screening for and management of IPV in primary care settings. Modifications include the use of an exam room computer as a kiosk for patient-generated health data entry, storage of data in a hidden location, the use of rule-based alerting methods to direct providers to access data, and electronic form-based tools for case management and documentation. While preserving privacy, this approach also allows access by provider type and authorized setting, including use for population health management. The approach was tested in a pilot study and found to be feasible, to have good compliance for provider screening (65%) and is being evaluated in a stepped-wedge trial in other primary care clinics across a large academic health system.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This work was funded by grant R18HS025654 from the Agency for Healthcare Research and Policy.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The IRB of the Medical University of South Carolina waived ethical approval for this work as a quality improvement study.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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