Leveraging the electronic medical record to implement an abdominal aortic aneurysm screening program

Area of Science:

• Vascular Surgery
• Preventive Medicine
• Health Informatics

Background:

• Abdominal aortic aneurysm (AAA) screening guidelines exist, yet remain underutilized in the U.S.
• A significant number of patients with ruptured AAA were undiagnosed prior to screening implementation.
• Medicare covers AAA screening ultrasound for at-risk male enrollees.

Purpose of the Study:

• To describe the design and implementation of an AAA screening program utilizing an electronic medical record (EMR).
• To reduce preventable AAA ruptures and deaths within an integrated healthcare system.
• To assess the early results of the EMR-based AAA screening program.

Main Methods:

• Targeted screening of men aged 65-75 with a history of smoking between March 2012 and June 2013.
• EMR-integrated best practice alerts (BPAs) prompted providers to order aortic ultrasounds.
• Standardized ultrasound reporting templates guided patient management for newly identified AAAs.

Main Results:

• The EMR-based screening program led to a significant increase in screening rates.
• The percentage of unscreened patients decreased from 51.74% to 20.26% system-wide.
• 731 new AAAs were diagnosed, with 165 measuring over 4.0 cm.

Conclusions:

• EMR implementation can dramatically reduce the number of unscreened patients for AAA.
• The screening program demonstrated successful implementation within an integrated healthcare system.
• Further research is needed to evaluate the program's impact on AAA rupture rates and cost-effectiveness.