Doctor builds tool to identify patients at risk for intimate partner violence

Doctor Develops Innovative Tool to Identify Patients at Risk for Intimate Partner Violence

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Introduction

In a groundbreaking effort to address the devastating issue of intimate partner violence (IPV), a South Carolina-based doctor has developed a cutting-edge electronic health record (EHR)-based screening tool. This revolutionary tool has been shown to be 10 times more effective than traditional methods in identifying victims of IPV, a condition that includes physical and sexual violence, stalking, and psychological aggression by a current or former partner. The new tool is a significant step forward in healthcare, aiming to create safer spaces for patients to share their experiences and seek help.

The Epidemic of Intimate Partner Violence

Intimate partner violence is a pervasive public health issue that affects millions of Americans. According to the Centers for Disease Control and Prevention (CDC), about one in four women and one in seven men experience IPV in their lifetime. This epidemic is not limited to any particular demographic; it affects people of all genders and sexual orientations, with higher rates reported among bisexual and transgender individuals. The consequences of IPV are severe, including physical trauma, chronic physical and mental health conditions, poor pregnancy outcomes, and even death.

The Need for Better Screening

Screening for IPV in primary care settings is crucial for early detection and support. However, traditional methods often fall short due to their lack of privacy, making it difficult for patients to open up about their experiences. The U.S. Preventive Services Task Force recommends IPV screening in primary care, but it remains underutilized in clinical settings. To address this gap, the new EHR-based screening tool prioritizes confidentiality and streamlines the screening process within clinical workflows.

Developing a Confidential, EHR-Based Solution

The innovative EHR-based screening system was developed by a team at the Medical University of South Carolina (MUSC). The team consisted of Leslie A. Lenert, M.D., Alyssa A. Rheingold, Ph.D., Vanessa Diaz, M.D., and Kit N. Simpson, DrPH. They designed the screener to assess physical and sexual violence and ensure that sensitive information was stored securely. Only the patient and provider could access the results, safeguarding the patient's privacy from potential abusers.

The screener was administered electronically to patients in primary care centers across South Carolina. Patients completed a private questionnaire on a computer without their partners present, ensuring that victims felt safe and unjudged. The tool was consulted with an advisory board of national experts, as well as an advisory board of victims and survivors of intimate partner violence, to gather their input on what screening tools would be the most successful.

Empowering Physicians and Patients

Integrating the new screening tool into daily clinical routines was crucial without adding to providers' demanding schedules. The chief of MUSC’s Primary Care Integrated Center of Clinical Excellence, Vanessa Diaz, emphasized the importance of giving patients a safe space through technology, where they felt comfortable answering personal and emotional questions. In addition to the new screening tool, providers were trained in best practices for discussing IPV and given resources for referring patients to support services. These efforts not only increased identification of IPV but also helped normalize the discussion of domestic violence in primary care.

How the Tool Works

The EHR-based screening tool works seamlessly within clinical workflows. Patients are handed a computer with a private questionnaire that they complete without their partners present. This ensures that victims feel safe and unjudged, allowing them to openly discuss their experiences without fear of retribution. The tool also includes noninterruptive clinician alerts to ensure that healthcare providers are notified if a patient screens positive for IPV. This approach provides maximum feasible protection for the privacy of the patient’s responses, reducing the risk of disclosure to a violent partner.

Best Practices for Implementation

Implementing effective IPV screening requires a comprehensive approach. Here are some best practices:

• Confidentiality: Providers should ensure confidentiality by seeing patients alone for part of the clinical visit. This helps build a strong, trusting relationship with the patient and creates a safe environment for disclosure.
• Universal Education + Empowerment: Providers can share safety cards with patients to help them discuss relationships and how they affect health. This evidence-based approach encourages patients to share safety cards with friends or family members, empowering them to seek help.
• Support: Providing patients with information about safety planning, legal resources, and counseling services is crucial. Referring patients to local advocacy organizations for additional support can also significantly help them.

The Future of IPV Screening

While the new EHR-based screening tool is a critical first step in addressing IPV, it is not a cure-all for the complex issue. The MUSC team acknowledges that most situations are complex and that there is a need for continued support and intervention. The goal is to make the doctor’s office a safe place where patients can discuss IPV and seek help without fear.

Leslie A. Lenert, M.D., emphasized the importance of making the doctor’s office a safe space for patients to discuss IPV and move forward with escaping abusive relationships. The researchers hope that their efforts will help bridge the gap in patient reporting and empower more women to seek assistance.

Conclusion

The development of an EHR-based screening tool for intimate partner violence is a significant milestone in addressing this public health issue. By prioritizing confidentiality and streamlining the screening process, this tool has the potential to save lives and improve the well-being of countless individuals. As healthcare providers continue to implement this innovative solution, it is crucial to remember that early detection and support are key to preventing the devastating consequences of IPV. By working together, we can create safer spaces for patients to share their experiences and seek the help they need.

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References

1. Confidential screening tool for intimate partner violence 10 times more effective than traditional methods
2. Screening for Intimate Partner Violence - Bedsider Providers
3. Intimate Partner Violence Screening Tools
4. Electronic Health Record–Based Screening for Intimate Partner Violence: A Cluster Randomized Clinical Trial