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Cited by 109Electronic Health Records SystemsHealth Promotion and Cardiovascular PreventionClinical practice guidelines implementation

The DOI matches its Crossref record; 21 of the 22 references it cites were found in a registry or an index.

Integrated electronic decision support increases cardiovascular disease risk assessment four fold in routine primary care practice

Open access
Wells, Sue, Furness, Sue, Rafter, Natasha, Horn, Elaine, Whittaker, Robyn, Stewart, Alistair, Moodabe, Kate, Roseman, Paul, Selak, Vanessa, Bramley, Dale, Jackson, Rod·2008·European Journal of Cardiovascular Prevention & Rehabilitation
DOI 10.1097/hjr.0b013e3282f13af4
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Abstract

BACKGROUND: A decade of cardiovascular disease (CVD) risk-based guidelines, education programmes and widespread availability of paper-based risk prediction charts have not significantly influenced targeting of CVD risk management in New Zealand primary care practice. A web-based decision support system (PREDICT-CVD), integrated with primary care electronic medical record software was developed as one strategy to address this problem. METHODS: A before-after audit of 3564 electronic patient records assessed the impact of electronic decision support on documentation of CVD risk and CVD risk factors. Participants were patients meeting national guideline criteria for CVD risk assessment, registered with 84/107 (78.5%) general practitioners (GPs) in one large primary care organization who used electronic patient medical records, and had PREDICT-CVD installed. The GPs received group education sessions, practice IT support and a small risk assessment payment. Four weeks of practice visit records were audited from 1 month after installation of PREDICT-CVD, and during the same 4-week period 12 months earlier. RESULTS: Less than 3% of eligible patients had a documented CVD risk before PREDICT-CVD installation. This increased four-fold (RR=4.0; 95% confidence interval 2.4-6.5) after installation and documentation of all relevant CVD risk factors also increased significantly. CONCLUSION: Documentation of CVD risk in primary care patient records in New Zealand is negligible, despite being recommended as a prerequisite for targeted treatment for over 10 years, suggesting that previous strategies were ineffective. We demonstrate that integrated electronic decision support can quadruple CVD risk assessment in just one cycle of patient visits.

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Citations

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Research works printed but not linked: 13

  1. National Heart Foundation, 1996, NZ Med J, 109, 224
  2. New Zealand Guidelines Group, 2003, The assessment and management of cardiovascular risk
  3. New Zealand Guidelines Group, 1998, Management of mildly raised blood pressure in New Zealand
  4. Jackson R, 2005, Lancet, 365, 434, 10.1016/S0140-6736(05)70240-3 · DOI
  5. Arroll B, 2002, NZ Fam Phys, 29, 177
  6. Ministry of Health, 2001, Family doctors: methodology and description of the activity of private GPs. The National Primary Medical Care Survey (NatMedCa)
  7. Rafter N, 2005, NZ Med J, 118, U1676
  8. Shea S, 1996, JAMIA, 3, 399
  9. Shiftman R, 1999, JAMA, 6, 104
  10. Wells S, 2005, Health Care Inform Rev Online, 1
  11. Eccles M, 2002, Qual Safety Health Care, 2002, 47
  12. Sinclair G, 2006, NZ Med J, 119, U2312
  13. Bonnevie L, 2005, Eur J Cardiovasc Prev Rehabil, 12, 52

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Metadata

Authors
Wells, S., Furness, S., Rafter, N., Horn, E., Whittaker, R., Stewart, A., Moodabe, K., Roseman, P., Selak, V., Bramley, D., & Jackson, R.
Affiliations
  • University of Auckland (NZ)
  • ProCare Health Ltd, Auckland, New Zealand
Corresponding author
Wells, Sue
ORCID
Venue
European Journal of Cardiovascular Prevention & Rehabilitation
Publisher
Oxford University Press (OUP)
Published
2008-04
Volume
15
Issue
2
Pages
173-178
ISSN
1741-8267 (ISSN-L)
DOI
10.1097/hjr.0b013e3282f13af4
OpenAlex
W2096963542
Cited by
109
References
22
Citations by year
2025: 3 · 2024: 8 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 4 · 2017: 5 · 2016: 6 · 2015: 6 · 2014: 7 · 2013: 12 · 2012: 18
FWCI
18.32
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • European Journal of Cardiovascular Prevention & Rehabilitation (publishedVersion)
  • PubMed (publishedVersion)
  • ResearchSpace (University of Auckland) (submittedVersion, cc-by)
Funders
  • Waitemata District Health Board
  • Ministry of Health, New Zealand
  • Health Research Council of New Zealand
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords
cardiovascular disease risk assessment, electronic decision support, primary care, electronic health records, general practitioners, practice audit
MeSH terms
Cardiovascular Diseases, Decision Support Techniques, Family Practice, Humans, Medical Audit, New Zealand, Primary Health Care, Retrospective Studies, Risk Factors, Software, Time Factors, Reproducibility of Results, Program Evaluation, Medical Records Systems, Computerized, Risk Assessment, Decision Support Systems, Clinical, Internet

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