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The objective of this proposal is to develop, implement, and test the effectiveness of a computerized clinical decision support system for hospitalized patients with heart failure.
Aim 1: Develop an electronic health record (EHR) based search method that uses both structured data and natural language processing of unstructured text to identify hospitalized patients with heart failure while they are still in the hospital.
Aim 2: Develop and test the usability of an electronic health record (EHR) based clinical decision support system (CDSS) to support delivery of evidence-based care to hospitalized heart failure patients using human computer interaction methods.
Aim 3: Assess the effect of an electronic health record (EHR) based clinical decision support system (CDSS) on processes of care for heart failure patients who are hospitalized for other causes. As part of the evaluation, we will test two implementation strategies, one of which will introduce the CDSS as an interruptive alert to providers, the second of which will introduce the CDSS as part of a provider checklist that exists on the side of the screen for each patient.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Active Alerting Mechanism | Experimental | Traditional Pop Up Alert used in Epic |
|
| Passive Alerting Mechanism | Active Comparator | Noninterruptive alert that sits in the checklist |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pop Up Interruption Alert | Other | Traditional Pop Up Alert used in Epic |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Percent of Patients with a Secondary Diagnoses of Heart Failure | These patients will also have had of left ventricular function (LV) Assessment either prior to or during the hospitalization or planned for post discharge | 90 Days |
| Percentage of patients with a secondary diagnosis of heart failure and LV systolic dysfunction who have been prescribed an Angiotensin-converting enzyme (ACE) inhibitor or Angiotensin II receptor blockers (ARB) | 90 Days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Saul Blecker, MD | New York University Medical School | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| New York University School of Medicine | New York | New York | 10016 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31525580 | Derived | Blecker S, Austrian JS, Horwitz LI, Kuperman G, Shelley D, Ferrauiola M, Katz SD. Interrupting providers with clinical decision support to improve care for heart failure. Int J Med Inform. 2019 Nov;131:103956. doi: 10.1016/j.ijmedinf.2019.103956. Epub 2019 Sep 4. |
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| ID | Term |
|---|---|
| D006333 | Heart Failure |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| Side Bar Non Interruptive Provider Checklist |
| Other |
Noninterruptive alert that sits in the checklist |
|