There was no significant difference in the time it took to construct a family health pedigree using an iPad application compared to using pen and paper. Both methods resulted in high participant satisfaction with the accuracy of the collected information. While over half of participants had exposure to tablet technology, under half requested an electronic copy of their pedigree and only a small portion planned to share the information with family or physicians. The iPad group was more likely to request an electronic copy of their pedigree.

1. Use of iPads in Pedigree Construction and Assessment
Andrew McCarty1, Laura Conway1, Kathy Valverde1, Heather Fecteau2, Lisa Kessler1
1Genetic Counseling Program, Arcadia University, Glenside, PA; 2Texas Health Resources, Dallas, TX
INTRODUCTION
The HITECH (Health Information Technology for
Economic and Clinical Health Act) act provides
incentives to health care systems to accelerate and
encourage the adoption of electronic health record
(EHR) systems. Integration of electronic pedigree
development programs into EHRs remains limited.
(University of Alabama, Department of Biostatistics,
2014). To date, little research has compared electronic
methods of pedigree construction with pencil and
paper.
PURPOSE
The purpose of the study was to compare using pen
and paper to collect family history with using
Proband©, an iPad application. Specific outcomes
assessed included: time to take the pedigree with each
method, the overall pedigree quality, and relationship
between participant and genetic counseling student
METHODS
Participant Recruitment
Arcadia students, faculty and staff over 18 years old
were eligible. A recruitment email informed participants
that demographics and family history information was
to be collected. Each participant received a $10 gift card
after completion of the survey.
Study Procedures
The study was conducted on the Arcadia University
campus. Participants were randomly assigned to have
histories collected with either pen and paper or
Proband©.
The following information was collected for each
individual in a three generation pedigree: age, number
of children, history of heart disease, birth defects,
cancer, and cause of death, when applicable. After the
family history interview, participants completed an
online survey via SurveyMonkey. Outcomes assessed:
time to take the pedigree, overall participant
satisfaction, and associated findings regarding use of
technology in healthcare.
RESULTS
50 individuals participated in the study. Only 48 were
included in analysis as two were unable to complete the
assessment. Participants were selected on a first come
first served basis. 24 participants were analyzed in the
iPad group and 24 participants in the pen and paper
group. See Table 1 for Sample Characteristics.
DISCUSSION
• In this study, using the iPad to record a family history is equally
effective in terms of efficiency and satisfaction as the traditional
pen and paper method.
• Overall, the efficiency of taking a family history did not show
significant difference between the two methods. Although other
studies, comparing other clinical data entry programs, have
found increases in speed with iPads, it is encouraging to see no
appreciable decreases in speed. (Glaser, Sanjula, & Kortum,
2013).
• The majority of the sample (72.9%) had exposure to tablet
technology either on a personal, education, or medical basis.
This reflects the growing trend of increasing adoption of
portable computer technology into many areas of society.
• Less than half of the participants in the study requested a copy
of the pedigree and only 14 participants planned to share the
family health information with other family members. Those
participants in the iPad group were more likely to request copies
of their pedigrees.
• Programs such as Proband© have the potential for benefit in a
healthcare system. The digital format may allow integration into
the EMR which could improve continuity of care between family
members, across practitioners and over time.
Figure 1. Satisfaction Between Groups
Table 1. Demographics (n=48)
Comfort with technology:
• 26 of 48 participants (54.2%) reported owning an iPad or
similar device.
• 34 of the 48 (70.8%) participants reported exposure to an
iPad in either an educational (n=32) or medical setting
(n=9).
• 46 of the 48 reported being comfortable with the idea of
having their medical information stored electronically.
• All participants in the iPad group and 23 of 24 participants in
the pen and paper group felt that the confidentiality of their
family health history was being maintained.
There was no significant difference in the time it took to draw a
pedigree between iPad and pen and paper with a 95% confidence
interval.
Acknowledgments
We would like to thank the participants who took the time to participate
in the survey and to thank Jeff Miller and the Proband© team at CHOP
for the use of the application. Furthermore, this project would not have
been possible without the generous support of the Ellington Beaver
Award for Intellectual Inquiry from Arcadia University.
The sample population was skewed toward female participants and those
30 years and under. Two thirds of the sample have completed at least a
bachelor’s level education.
Overall Satisfaction
Figure 1. Satisfaction with
Accuracy of the Pedigree
REFERENCES
Glaser, D., Sanjula, J., & Kortum, P. (2013, September 2). Benefits of a
physician-facing tablet presentation of patient symptom data: comparing
paper and electronic formats. BMC Medical Informatics and Decision
Making.
University of Alabama, Department of Biostatistics. (2014, Nov). Pedigree
Drawing Programs. Birmingham, Alabama, US: School of Public Health.
Retrieved from http://www.soph.uab.edu/ssg/linkage/pedigreedrawing
0
5
10
15
20
25
ipad pen and
paper
Satisfaction with perceived accuracy of
information was high in both groups and
no significant difference was found.
Table 2. Family Size and Time Needed to Draw Pedigree
Communication of Family Health History Information
23 of the 48 participants requested a copy of their family
pedigree for their records:
• 13 reported plans to share this information with their family
• One participant planned to share the information with his/her
physician
• One planned to share with both his/her family and physician
• Eight participants reported not knowing what they would do
with the family health information.
• More participants in the iPad group requested copies of their
pedigree (See Figure 2)
0
5
10
15
20
25
ipad pen and
paper
Figure 2. Participants
who requested
pedigree
More participants in the iPad group
requested a pedigree. This was
found to be statistically significant.
c2=6.76, P<0.05