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

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dc.contributor.author Wells, Linda en
dc.contributor.author Furness, SJ en
dc.contributor.author Rafter, N en
dc.contributor.author Horn, E en
dc.contributor.author Whittaker, Robyn en
dc.contributor.author Stewart, Alistair en
dc.contributor.author Moodabe, K en
dc.contributor.author Roseman, P en
dc.contributor.author Selak, Vanessa en
dc.contributor.author Bramley, D en
dc.contributor.author Jackson, Rodney en
dc.date.accessioned 2012-04-02T01:26:19Z en
dc.date.issued 2008 en
dc.identifier.citation European Journal of Cardiovascular Prevention and Rehabilitation 15(2):173-178 Apr 2008 en
dc.identifier.issn 1741-8267 en
dc.identifier.uri http://hdl.handle.net/2292/16332 en
dc.description.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. en
dc.publisher SAGE Publications en
dc.relation.ispartofseries European Journal of Cardiovascular Prevention & Rehabilitation en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from: http://www.sherpa.ac.uk/romeo/issn/1741-8267/ en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Integrated electronic decision support increases cardiovascular disease risk assessment four fold in routine primary care practice en
dc.type Journal Article en
dc.identifier.doi 10.1097/HJR.0b013e3282f13af4 en
pubs.begin-page 173 en
pubs.volume 15 en
dc.rights.holder Copyright: SAGE Publications en
dc.identifier.pmid 18391644 en
pubs.end-page 178 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 90313 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Population Health en
pubs.org-id Epidemiology & Biostatistics en
pubs.record-created-at-source-date 2010-09-01 en
pubs.dimensions-id 18391644 en


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