AJMC: EHRs help keep cardiac patients healthy
An EHR program cut cardiac deaths by 73 percent through linking coronary artery disease patients and teams of pharmacists, nurses, primary care doctors and cardiologists with an EHR. It also kept the patients healthy two years after they left the program by keeping them in touch with their caregivers electronically, according to a randomized trial published in this month's American Journal of Managed Care.
The study, funded by the American College of Clinical Pharmacy, sought to evaluate a follow-up system for patients discharged from a cardiovascular risk reduction service, according to the researchers.
The two-year trial of 421 patients found that patients discharged from the program kept their lipid and blood pressure levels at controlled, healthy levels by receiving electronic reminders. The clinical pharmacy cardiac risk service at Kaiser Permanente (KP) Colorado combines Kaiser's EHR--KP HealthConnect--with patient outreach, education, lifestyle adjustments and medication management.
"Because lack of adherence to medications and failure to maintain treatment goals are so high among heart disease patients, we wanted to find out what would happen to the patients after they were discharged from the program but remained in contact with the healthcare system through our EHR," said the study's lead author Kari L. Olson, a clinical pharmacy specialist with Kaiser's Cardiac Risk Reduction program in Denver. "The takeaway message here is that we can help support patients in maintaining treatment goals and medication adherence, which is often a challenge with most chronic conditions. Using technology and integrated systems already in place, we can help keep patients healthy for longer and deliver continuity of care in a cost-efficient manner."
In the study, 421 patients with well-controlled blood pressure and cholesterol levels were randomized, so that 214 continued to receive intensive direct counseling and the other 207 patients were discharged from the program back to their primary care physician. The mean age of the trial participants was 72 years old, and 74 percent were male.
The patients who were discharged from the program had electronic reminders in their chart to ensure their lipid panels were ordered annually, with the results sent to their primary care physician. The discharged patients also received reminder letters generated by KP HealthConnect, indicating they were due for a lab test.
Importantly, the study found that patients discharged from the program maintained control of their risk factors with the help of electronic reminder letters. The EHR intervention was as effective at keeping cholesterol and blood pressure in check, compared with the more intensive counseling approach offered to those patients who stayed enrolled in the program.
In the study, the researchers estimated that more than 135 deaths and 260 costly emergency interventions were prevented annually as a result of improved care. Also, the results suggest that once the program has helped get risk factors under control, patients can then be discharged and followed virtually with the same success.
The broader program also achieved these previously reported results:
The study, funded by the American College of Clinical Pharmacy, sought to evaluate a follow-up system for patients discharged from a cardiovascular risk reduction service, according to the researchers.
The two-year trial of 421 patients found that patients discharged from the program kept their lipid and blood pressure levels at controlled, healthy levels by receiving electronic reminders. The clinical pharmacy cardiac risk service at Kaiser Permanente (KP) Colorado combines Kaiser's EHR--KP HealthConnect--with patient outreach, education, lifestyle adjustments and medication management.
"Because lack of adherence to medications and failure to maintain treatment goals are so high among heart disease patients, we wanted to find out what would happen to the patients after they were discharged from the program but remained in contact with the healthcare system through our EHR," said the study's lead author Kari L. Olson, a clinical pharmacy specialist with Kaiser's Cardiac Risk Reduction program in Denver. "The takeaway message here is that we can help support patients in maintaining treatment goals and medication adherence, which is often a challenge with most chronic conditions. Using technology and integrated systems already in place, we can help keep patients healthy for longer and deliver continuity of care in a cost-efficient manner."
In the study, 421 patients with well-controlled blood pressure and cholesterol levels were randomized, so that 214 continued to receive intensive direct counseling and the other 207 patients were discharged from the program back to their primary care physician. The mean age of the trial participants was 72 years old, and 74 percent were male.
The patients who were discharged from the program had electronic reminders in their chart to ensure their lipid panels were ordered annually, with the results sent to their primary care physician. The discharged patients also received reminder letters generated by KP HealthConnect, indicating they were due for a lab test.
Importantly, the study found that patients discharged from the program maintained control of their risk factors with the help of electronic reminder letters. The EHR intervention was as effective at keeping cholesterol and blood pressure in check, compared with the more intensive counseling approach offered to those patients who stayed enrolled in the program.
In the study, the researchers estimated that more than 135 deaths and 260 costly emergency interventions were prevented annually as a result of improved care. Also, the results suggest that once the program has helped get risk factors under control, patients can then be discharged and followed virtually with the same success.
The broader program also achieved these previously reported results:
- Patients have an 88 percent reduced risk of dying of a cardiac-related cause when enrolled within 90 days of a heart attack, compared with those not in the program;
- The number of patients meeting their cholesterol goal went from 26 percent to 73 percent, and;
- The number of patients screened for cholesterol went from 55 percent to 97 percent.