Evaluating the Reach of Clinical Decision Support for Patients with Heart Failure
Keywords
Health equity; social determinants of health
Types of Research
Dissemination and implementation research; practice based research
Summary
The goal of this project is to create a clinical decision support (CDS) tool that is designed to enhance goal directed medical therapy for patients with heart failure during virtual visits. A focus of this work is to ensure diverse types of patients are equitably benefitted from CDS recommendations irrespective of whether they receive care via virtual or in person visits. In Aim 1 we will use electronic health record data to determine how care is being received by patients with heart failure within the UCHealth system, including how people from different populations (e.g., race, ethnicity, rural settings, language, digital divide) use virtual versus in person visits. In Aim 2 we will develop a clinical decision support tool designed to enhance GDMT prescribing during virtual visits for diverse types of patients using partner engagement and user centered design methods. In Aim 3 we plan to conduct an RCT of the CDS tool designed in Aim 2 specifically for virtual visits compared to a CDS designed for in person visits.
Significance
Goal directed medical therapy (GDMT) for heart failure is life prolonging but under prescribed. While CDS has been used to enhance GDMT prescribing during in-person visits, none has been developed for virtual visits. This creates a potential disparity in the quality of care received virtually.
Impact
This study has the potential to substantially improve prescribing of GDMT and outcomes for high-risk patients with HFrEF. The results of this study will also provide methodological insights to others who wish to design CDS for virtual visits.
Health Equity Implications
This project focuses on health equity through diverse partner engagement throughout all stages of development of the CDS tool and plans to evaluate for equity of GDMT prescribing related to the CDS developed in this project to ensure it enhances health equity.
Lessons Learned
This 6 month RCT is live in UCHealth outpatient cardiology virtual visits as of February 25, 2025.