EHRs Keepin' People Heart Healthy

A program that cut cardiac deaths 73% by using an electronic health record to link coronary artery disease patients with teams of caregivers has now been shown to prolong these benefits for 2 years using an inexpensive, EHR-derived reminder system.

The program involves Kaiser Permanente’s HealthConnect EHR. The new study was a randomized, controlled trial comparing the inexpensive approach with a continuation of the resource-intensive approach that generated the breakthroughs in the first place.

The write-up appears in this month’s American Journal of Managed Care.

This is the first randomized study to evaluate a follow-up system for patients discharged from a cardiovascular risk reduction service, according to Kari Olson, a Clinical Pharmacy Specialist with Kaiser Permanente Colorado’s Cardiac Risk Reduction program and the study’s lead author.

In the study, 421 CCRP patients with well-controlled blood pressure and cholesterol levels were randomized so that 214 continued in the program to receive intensive direct counseling from the care team and the others were discharged back to their primary care physician.

PCPs caring for patients that had been discharged from the program had electronic reminders added to their chart to ensure lipid panels were ordered annually. Results of these tests were sent automatically to the PCP. In addition, patients received EHR-generated reminder letters indicating they were due for lab testing.

The EHR intervention was as effective at keeping cholesterol and blood pressure in check as the intensive counseling approach.

“The takeaway message is that we can support patients...using technology and integrated systems already in place. We can keep patients healthy for longer and deliver continuity of care in a cost-efficient manner,” Olson concluded.

In all, CCRP follows 13,000 cardiac patients. Kaiser estimates the service prevents about 135 deaths and 260 ER visits per year.

Glenn Laffel MD, PhD, Sr. VP Clinical Affairs, Practice Fusion