Confidential Screening for and Management of Intimate Partner Violence Risk using a Commercial Electronic Health Records System

Intimate partner violence is, unfortunately, a common problem (25% of women) for which screening in primary care is a recommended service. In this paper, we describe modifications to a commercial EHR system (Epic) designed to support confidential screening for and management of IPV in primary care settings. Modifications include the use of an exam room computer as a kiosk for patient-generated health data entry, storage of data in a hidden location, the use of rule-based alerting methods to direct providers to access data, and electronic form-based tools for case management and documentation. While preserving privacy, this approach also allows access by provider type and authorized setting, including use for population health management. The approach was tested in a pilot study and found to be feasible, to have good compliance for provider screening (65%) and is being evaluated in a stepped-wedge trial in other primary care clinics across a large academic health system.