Abstract MP12: Electronic Health Record-Based Assessment of Cardiovascular Health

Abstract

INTRODUCTION: An electronic health record (EHR)-based visualization tool was developed to facilitate patient-provider communication around the American Heart Association’s (AHA) Life’s Simple 7™ for cardiovascular health (CVH). The tool automatically populates with patient data from the EHR and utilizes a stoplight color scheme to indicate “ideal” (green), “intermediate” (yellow), and “poor” (red) CVH. METHODS: CVH was defined for smoking, body mass index, blood pressure, and cholesterol according to AHA criteria. For this analysis, diabetes was characterized as either yellow (treated) or green (untreated), as most patients were missing fasting glucose values. An overall CVH score was calculated and ranged from 0 (worst) to 10 (best) by summing across behaviors and factors as follows: poor, 0; intermediate, 1; and ideal, 2. The CVH tool first launched within the EHR of our outpatient intervention clinic in October 2013. The change in CVH of female patients ages 65 and older seen in the clinic during the pre-intervention period (May 1 - July 31, 2013) and the post-intervention period (May 1 - July 31, 2014) was described. RESULTS: One hundred nine women (average age 74 years; 35% black), seen pre- and post-intervention, were enrolled in the study. The mean CVH score was 6.0 and the mean fractional score (actual score/maximum possible) was 0.63 at both time points, and neither differed significantly by race. Figure 1 shows the distribution of ideal, intermediate, poor, and missing CVH values for each behavior and factor in 2013 and 2014. From 2013 to 2014, the proportion of obese women decreased from 47% to 43%, and the proportion of normal-weight women increased from 15% to 19%. Favorable changes were also seen for diabetes. CONCLUSIONS: This is the first study to develop and implement an EHR-based CVH visualization tool. Our study demonstrates that it is feasible to implement patient-centered EHR-based tools at the point-of-care in the primary care setting. Future work is needed to assess how to best harness the potential of such tools.