en.Wedoany.com Reported - The firearm injury risk screening tool developed by Northwell Health has been integrated into the Epic electronic health record system and is now available for use by healthcare institutions nationwide.
The screening tool embeds two core assessments in the electronic health record: whether the patient has access to firearms and whether they are exposed to community violence risk. Each healthcare institution can decide on subsequent intervention measures and referral pathways based on positive screening results.
Dr. Chethan Sathya, director of Northwell's Center for Gun Violence Prevention, stated that healthcare providers have had evidence-based intervention strategies for decades, including counseling patients on safe firearm storage and providing guidance to adolescents. However, as of 2019, fewer than 8% of adults in households with firearms had discussed firearm safety with a healthcare provider. Sathya believes that such screening should become part of standard care.
According to Northwell, this screening protocol is the first of its kind for emergency clinicians and was developed by the health system through research funded by the National Institutes of Health. Since 2020, Northwell has used this method to screen over 250,000 emergency department patients, with approximately 15% testing positive and being referred to resources such as hospital-based violence intervention programs.
The screening primarily consists of two questions: whether the patient can access firearms inside or outside their home, and whether, in the past six months, the patient has heard gunshots or had a gun pointed at them. Sathya noted that the latter question has a 95% accuracy rate in predicting community violence risk. These two questions assess firearm access and community violence risk separately, as they are fundamentally different: firearm suicides and accidental injuries are closely related to safe storage, while firearm homicides—the most common form of interpersonal community violence in the United States—are associated with risk factors such as social isolation and unemployment.
The integration of this tool with the Epic system offers two key advantages. First, it simplifies clinician workflow and promotes adoption. Sathya emphasized that one of the biggest barriers to implementing screening in clinician workflows is the integration with electronic health record systems. Second, it standardizes data collection to support research and prevention efforts. Sathya noted that there was previously almost no available data on the questions being asked, and this integration marks the starting point for data accumulation.
As outlined in Northwell's implementation toolkit, Sathya recommends that hospitals deploying the screening tool establish corresponding intervention pathways to support positive patients. Hospitals need to understand local resources, including firearm lock options and community organizations addressing other social determinants of health, and communicate with key departments and staff before screening to ensure everyone is clear on the screening program and protocol. Northwell will soon publish follow-up outcome data for positive patients at three and six months to observe whether positive behavioral changes occur. Sathya stated that Northwell has already seen good results.
Additionally, New York State Governor Kathy Hochul has announced a state-funded pilot program to integrate Northwell's screening tool into emergency departments statewide. Northwell's Center for Gun Violence Prevention will provide training, technical assistance, coordination, and support for the three participating institutions.
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