Raef Fadel Joseph B. Miller MD Hanan Ibrahim Rawan Hammoudeh Guneet Ahluwalia Tamara Roumayah Megan Scott Nitesh Gandhi John France Thomas Theoharis Jacob Ross
Henry Ford Health System
05-01-2019
Background: Primary care management of essential hypertension (HTN) has become increasingly challenging since recently published guidelines integrate atherosclerotic cardiovascular disease (ASCVD) ris..
Background: Primary care management of essential hypertension (HTN) has become increasingly challenging since recently published guidelines integrate atherosclerotic cardiovascular disease (ASCVD) risk stratification into decision making. Our objective was to measure whether overlay of visualdecision support (VDS) with standard electronic health record (EHR) platform improves guideline-based treatment, and reduces time burden associated with EHR use, in management of essential HTN. Methods: This was a quality improvement project. We interviewed primary care physicians and tasked each with two simulated patient encounters for HTN: (1) using standard EHR to guide treatment, and (2) using VDS to guide treatment. The VDS included graphical blood pressure (BP) trends, target BP with recommended interventions, ASCVD risk score, and information on the patient’s social determinants of health. We assessed whether treatment selection was congruent with guidelines and tracked time physicians consulted the EHR. Results: We evaluated 70 case simulations in total. Use of VDS compared to usual EHR was associated with: higher proportion of correct guideline prescribing (94% vs. 60%, p
