Primary care patient and clinician attitudes about population genomic screening, informed decision-making needs, and the potential for Chatbot technology

Abstract

The three CDC Tier 1 conditions (Hereditary Breast and Ovarian Cancer, Lynch Syndrome, and Familial Hypercholesterolemia) are estimated to affect 2 million people in the United States. Population-based genomic screening holds promise in identifying individuals who may not know their risk. This novel study explored primary care clinician and patient attitudes toward population screening generally and in the context of a research study and the potential for chatbot technology to support informed decision-making in the primary care context, perspectives vital to inform scalable, patient-centered approaches to facilitate population screening. We conducted semistructured interviews with primary care patients (N = 20) and primary care clinicians (N = 9) from primary care clinics at a patient-diverse academic medical center. The interviews focused on receptivity to population-level screening, information needs, and the potential for chatbot technology as a mechanism to support patient informed decision-aking about testing. Patient and clinician participants also reviewed a brief demonstration of the chatbot technology and shared their views. Interviews were recorded and transcribed. We used rapid qualitative analysis methodology to analyze interview data. Patients and clinicians acknowledged the benefits of population genomic screening and found the chatbot technology to be easy to navigate. Patients endorsed the utility of screening but raised concerns about data privacy and the desire for more information about the conditions and screening process. Clinicians gave insights into information that could be integrated to further support patients in informed decision-making. Overall, chatbot technology as a facilitator of population screening is a promising approach. The results of this study can improve future efforts to ensure that chatbots and similar technology incorporate vital information to facilitate informed decisions.