Pregnancy and health profile: A screening and risk assessment tool
The March of Dimes offers a free, easy-to-use, tablet PC-based software that helps primary prenatal providers identify and then discuss with their patients certain genetic risks based on family health history. Features, including clinical decision support, red flags and point-of-care fact sheets, help you and your patients make shared, informed decisions about prenatal testing and screening options.
The tool has been tested in diverse clinical settings with more than 75 primary prenatal care providers and more than 600 highly satisfied patients. It is currently available as a PC-based tool in English; an iPad® version and versions in other languages depend on additional funding and collaboration opportunities.
The Pregnancy and Health Profile replaces all the paper health questionnaires that a woman usually fills out at her prenatal provider’s office. The tool streamlines the patient intake process. And during the clinical encounter, it offers up-to-date information on a variety of genetic conditions and risk factors personalized for each patient. For example, the tool can generate consumer-friendly fact sheets for your patient as well as clinical decision support messages and provider-focused fact sheets for you.
The March of Dimes developed this tool in collaboration with the National Coalition for Health Professional Education in Genetics (NCHPEG) and other partners. Visit nchpeg.org to download the free software.
How can the Pregnancy and Health Profile help you in clinical practice?
The profile tool can help you:
- Improve identification of women and babies at increased risk for genetic disease and pregnancy complications.
- Provide timely recommendations and support for ordering genetic tests and managing genetic risk factors
- Stay informed and adhere to standards of care based on professional society guidelines
- Improve patient outcomes based on standards of care
- Provide relevant information about tests and risks to patients
- Empower and educate patients with instructional messages and videos
- Promote shared decision-making with your patients
- Streamline the patient-intake process
- Save time in your busy practice
How does the tool fit into your clinic flow?
Here’s how you and your patient use the tool:
- A woman uses a tablet PC in the waiting room or exam room to fill out the Pregnancy and Family History Questionnaire, a comprehensive, patient-friendly form used to collect intake information. She enters medical and family history information for herself and her baby’s father, as well as demographic and lifestyle factors that may affect her health and her baby’s health. Pilot testing has shown that the questionnaire can be completed in less than 20 minutes.
- Evidence-based algorithms automatically assess the patient’s risk and provide point-of-care guidance to you, the provider. For example, the tool may produce a 3-generation pedigree based on the woman’s information. You can access this information through the software’s “clinician dashboard” and can even print it for later use.
- During the patient visit, you and the patient begin the process of shared decision-making. You can discuss relevant risks and possible choices the patient has, including genetic testing or referral to specialists. You can share printed fact sheets with the patient, generated by the tool based on the information provided by the patient.
- During or after the patient visit, you can review, modify and document patient risk factors. For example, if the patient clarifies a response she made in the questionnaire, you can update and re-run the risk assessment based on new information.
Can you use the tool with electronic health records?
Yes. You can save patient information from the tool to your existing electronic health record (also called EHR). Each EHR system collects and stores patient information in a unique way. The tool uses family health history data standards developed by Health Level 7, the same data standards used by the U.S. Surgeon General’s My Family Portrait. You can customize the process of importing patient information from the tool into your EHR. If you don’t use an EHR, you can use the tool as a stand-alone method of collecting patient information. For more information, contact firstname.lastname@example.org.
Is the tool customizable?
Yes. You can customize the Pregnancy and Health Profile to meet the needs of you, your staff and your patients. Customization can include:
- Adding your practice or hospital logo to the patient report or rearranging sections of the report
- Sharing information between the tool and your appointment tracking system
- Turning on/off various clinical decision support messages
- Uploading patient information into your EHR
March of Dimes can provide training to you and your staff on the value of family health history and integrating the Pregnancy and Health Profile into your everyday practice. For more information, please send us a message on the form on Ask our experts.
Does the tool require a wireless connection to the internet?
No. You can use the tool by itself as a stand-alone product. However, a secure, wireless intranet connection can make the tool easier to use, especially if you see patients in several places or if your waiting room is on a different floor than your exam rooms. If you have questions, send an email to Ask our experts.
Where can you find out more information about the tool?
Visit nchpeg.org for more information on the Pregnancy and Health Profile, including:
- Components of the tool, including screen shots and a list of genetic conditions for which clinical decision support is provided
- The patient questionnaire
- Video demonstration of the tool
- Sample patient and provider fact sheets
- Continuing education materials, including a grand rounds slide set
- A sample provider report
- Press coverage about the tool
- Scientific presentations and publications about the tool
- Other supporting materials to help you effectively integrate the tool into your practice
This web article is supported by grant U33MC12786 from the Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau, Genetic Services Branch, as part of the Family Health History for Prenatal Providers project. Partners in the project include HRSA, March of Dimes Foundation, National Coalition for Health Professional Education in Genetics, Genetic Alliance and Harvard Partners.
The Pregnancy and Health Profile is to be used by qualified healthcare providers for informational and educational purposes only and is not intended to replace or overrule the qualified healthcare provider’s judgment or clinical diagnosis.
Frequently Asked Questions
Does the March of Dimes provide information about birth defects?
Yes. The March of Dimes produces fact sheets on several birth defects, including autism, chromosomal abnormalities, cleft lip, congenital heart defects and Down syndrome. Simply type the name of the birth defect into the search box.
What happens during a preconception checkup?
A preconception checkup can help assure that a woman is as healthy as possible before she conceives. Her provider can identify and often treat health conditions that can pose a risk in pregnancy, such as high blood pressure, diabetes or certain infections. During the visit, the woman can learn about nutrition, weight, smoking, drinking alcohol and occupational exposures that can pose pregnancy risks. The provider also can make sure a woman’s vaccinations are up to date and that any medications she takes are safe during pregnancy. The woman and her provider can discuss her health history and that of her partner and family. If the woman or her partner has a history of birth defects or preterm birth or if either has a high risk for a genetic disorder based on family history, ethnic background or age, the provider may suggest seeing a genetic counselor.
What is a birth defect?
A birth defect is an abnormality of structure, function or metabolism (body chemistry) present at birth that results in physical or intellectual disabilities or death. Thousands of different birth defects have been identified. Birth defects are the leading cause of death in the first year of life.
See also: Common birth defects
What newborn screening tests does the March of Dimes recommend?
The March of Dimes would like to see all babies in all states screened for at least 31 health conditions. Many of these health conditions can be treated if found early.
All states require newborn screening for at least 26 health conditions. Some states require screening for additional conditions – some up to 50 or more. For more information, read our article on newborn screening.