Health Information Technology in Heart Failure Care

NCT02858674 | Completed

• 1 other identifier: 14-01555
• Study Type: interventional
• Target: 958
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Heart Failure

Outcome Measures

Primary Outcomes (2)

• 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

Study Arms (2)

Active Alerting Mechanism

EXPERIMENTAL

Traditional Pop Up Alert used in Epic

Other: Pop Up Interruption Alert

Passive Alerting Mechanism

ACTIVE COMPARATOR

Noninterruptive alert that sits in the checklist

Other: Side Bar Non Interruptive Provider Checklist

Interventions

Pop Up Interruption Alert OTHER

Traditional Pop Up Alert used in Epic

Active Alerting Mechanism

Side Bar Non Interruptive Provider Checklist OTHER

Noninterruptive alert that sits in the checklist

Passive Alerting Mechanism

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients hospitalized 2 years prior and 18 months after the time of implementation of the Computerized clinical decision support systems (CDSS) in the (Electronic Health Record (EHR).

You may not qualify if:

• Patients on the obstetrical service, who died during hospitalization, or on hospice care.

Sponsors & Collaborators

• NYU Langone Health: lead

Study Sites (1)

New York University School of Medicine

New York, New York, 10016, United States

Location

Related Publications (1)

• 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.

  PMID: 31525580 DERIVED

MeSH Terms

Conditions

Heart Failure

Condition Hierarchy (Ancestors)

Heart Diseases; Cardiovascular Diseases

Study Officials

• Saul Blecker, MD

  New York University Medical School

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 3, 2016
• First Posted: August 8, 2016
• Study Start: April 1, 2017
• Primary Completion: March 31, 2018
• Study Completion: March 31, 2018
• Last Updated: November 8, 2019

Record last verified: 2019-11

Locations

US (1)