TY - JOUR T1 - Time to rethink the capture and use of family history in primary care JF - British Journal of General Practice JO - Br J Gen Pract SP - 627 LP - 628 DO - 10.3399/bjgp16X688273 VL - 66 IS - 653 AU - Paul A Nathan AU - Owen Johnson AU - Susan Clamp AU - Jeremy C Wyatt Y1 - 2016/12/01 UR - http://bjgp.org/content/66/653/627.abstract N2 - Since Hippocrates, doctors have recognised the value of family history.1 It is less clear how GPs should use this information now that gene sequencing and electronic medical records are redefining what is possible. In rare genetic diseases, family history highlights important risks but shared ethnicity, culture, diet, and environment mean that family history is also a risk factor for many common conditions such as cancer, cardiovascular disease, and dementia. The UK’s relatively poor outcomes in cancer, for example, have been partly attributed to reluctance by primary care physicians to investigate possible cancer.2 Genetic clinics require patients to be identified in primary care before a referral is made, and GPs could make significant use of family history to do this.In the US, every Thanksgiving Day since 2004 has been declared a ‘National Family History Day’ with promotion of My Family Health Portrait (https://familyhistory.hhs.gov), an online tool for families to record their relationships and relevant diseases.3 Such patient-led tools can link to online resources such as Microsoft HealthVault but not to clinical systems, at least not yet. Rubin et al presented a model in the BJGP to improve early diagnosis from referral to treatment.2 In this Debate and Analysis we argue for an earlier step — linking patient-led online family pedigree tools with primary care electronic health records to inform early risk assessment, lifestyle choices, and diagnostic screening instead of waiting for patients to present with signs of illness.Patients often present to discuss their genetic risk following a family gathering (Christmas, weddings, or funerals) where information about a … ER -