Dr. Linda Hunt and Dr. Heather Howard have been awarded a major National Institute of Health (NIH) grant to study the complex relationships between electronic health records, genomic concepts, clinical decision-making, and patient self-perception. Their study is designed to: 1) Examine how clinicians integrate genomic concepts with their existing understandings of racial identity, risk and responsibility, 2) Understand how patients interpret these complex concepts, and 3) Examine how electronic health records systems may promote concepts of biological racial/ethnic difference, and the consequences of these practices for individual clinicians and patients.
The focus of the study will be diabetes management clinics currently using electronic health record systems (EHRs). The use of EHRs is expanding rapidly, and is intended to improve efficiency and increase standardization. However their rapid implementation has occurred without careful consideration of how their use may be redefining clinical care. Drs. Hunt and Howard seek to identify ways that concepts of genomic difference are being articulated in EHRs, and consider how clinical care may be changed by the use of these new technologies. They want to address how different racial and ethnic group identities are treated within this changing landscape of health care. The project is designed to produce broad insights into the impact of new technologies on clinical care, so that these technologies may be implemented in ways that maximize equal access and unbiased treatment for diverse groups.
The grant will provide multiple years of support for ethnographic research, including participant observation in diabetes management centers, of clinical consultations, nutritional counseling sessions, support groups and any other health services patients may be receiving. They will also conduct interviews with patients and practitioners, and review electronic health records as they are used throughout the process of care.
Dr. Hunt and Dr. Howard’s research is important because it demonstrates how an anthropological lens can be used to critically consider how healthcare is being transformed through increasing reliance on genomic concepts, and use of EHRs. Their approach will provide an ethnographic perspective on the ways these innovations are entering into routine practices of everyday health care and their immediate impact on individual clinicians and patients.
[This Article is featured in the Winter 2014 Department of Anthropology Newsletter]