Health Information Technology in Heart Failure Care

Study Overview
=================
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.

Official Title
-----------------
Health Information Technology in Heart Failure Care

Conditions
-----------------
Heart Failure

Intervention / Treatment
-----------------
* Other: Pop Up Interruption Alert
* Other: Side Bar Non Interruptive Provider Checklist


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: 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). Exclusion Criteria: Patients on the obstetrical service, who died during hospitalization, or on hospice care.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Active Alerting Mechanism<br>Traditional Pop Up Alert used in Epic | Other: Pop Up Interruption Alert<br>* Traditional Pop Up Alert used in Epic<br>|
| Active Comparator: Passive Alerting Mechanism<br>Noninterruptive alert that sits in the checklist | Other: Side Bar Non Interruptive Provider Checklist<br>* Noninterruptive alert that sits in the checklist<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | 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 |