Abstract 11885: An App That Brings Guidelines to the Point-of-Care: A Pathway for Anticoagulation in Prosthetic Heart Valves

Abstract

Introduction: AHA/ACC guidelines are updated regularly, but their clinical implementation at bedside or in the clinic is cumbersome, complicated, and difficult. Apps may fill this gap by bringing medical guidelines to the physician at the bedside. We built the AHA/ACC guidelines as an interactive app that makes the guidelines accessible at the point-of care. This app, in turn, saves time, increases efficiency, and improves the quality of care. Method: While reviewing the AHA/ACC guidelines, we realized that several unique flowcharts can be created each with endpoints being the recommendation for a specific patient characteristic. We used Google App Script and build a spreadsheet-based branching-tree questionnaire with data entry points (e.g., segmented buttons, text data field, or multiple-item selectors) for data inputs. Our data inputs were based on the most recent AHA/ACC guidelines. A unique trigger was set to each data entry item, allowing branching of questions and the users being exposed to a specific subset of questions at each selection. On completion of the clinical module, the app script packages the contents into multiple CSV files (dashboard, pages, contents of each page, and references), and sends the files to Google Firebase, which is Google’s real-time database. In the end, the final recommendation presented is the specific section of the AHA/ACC guideline pertaining to the characteristics of the patient as entered by the user. Qualitative feedback found our app to be “more usable” than the traditional review of guidelines on the website or a paper printout. A subset of the questions for “anticoagulation in prosthetic heart valve patients” is shown in Figure 1. This example represents one of the many modules designed on the same principle. Conclusion: Our interactive app based on AHA/ACC guideline can both save time and improve the quality of care. The app is called “AvoMD”, and we made it available for free on app stores to help clinicians in their practice.