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Real-time electronic medical record alerts increase high blood pressure recognition in children

Tammy M Brady1, Alicia M Neu2, Edgar R Miller2

  • 1Johns Hopkins University, Baltimore, MD, USA tbrady8@jhmi.edu.

Clinical Pediatrics
|November 23, 2014
PubMed

Insights

Electronic medical record alerts significantly improved the recognition of elevated blood pressure (BP) in children. Despite this improvement, further strategies are needed to address the persistent underrecognition of pediatric hypertension.

Area of Science:

  • Pediatrics
  • Cardiology
  • Health Informatics

Background:

  • Pediatric hypertension is frequently unrecognized in primary care settings.
  • Early identification of elevated blood pressure (BP) is crucial for preventing long-term cardiovascular disease (CVD).

Purpose of the Study:

  • To evaluate the effectiveness of an electronic medical record (EMR) alert system in improving the recognition of elevated BP in children.
  • To assess the impact of the EMR alert on the relationship between cardiovascular disease (CVD) risk factors and BP recognition.

Main Methods:

  • A pre-post study design was employed, evaluating a real-time EMR alert and an educational session.
  • Included 1305 encounters of children aged 3-21 with elevated BP and no prior hypertension diagnosis.
  • Compared BP recognition rates and their association with CVD risk factors before and after the intervention.

Main Results:

  • Elevated BP recognition increased significantly from 12.5% to 42% (P < .001) after alert implementation.
  • The increase in recognition was sustained over time without significant alert fatigue.
  • Cardiovascular disease risk factors remained associated with recognition, but to a lesser extent during the intervention period.

Conclusions:

  • Real-time EMR alerts are effective in substantially increasing the recognition of elevated BP in pediatric patients.
  • Despite the EMR alert's success, underrecognition of elevated BP persists, indicating a need for additional interventions to enhance provider awareness and management.
Abstract

Keywords:
automatedcardiovascular healthcomputer alertelectronic health recordhypertensionpediatricsprimary carequality improvementscreeningtriage

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