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An Implementation Science Framework to Develop a Clinical Decision Support Tool for Familial Hypercholesterolemia.

Hana Bangash1, Laurie Pencille2, Justin H Gundelach1

  • 1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA.

Journal of Personalized Medicine
|July 29, 2020
PubMed
Summary

Electronic health record (EHR) clinical decision support (CDS) tools can improve familial hypercholesterolemia (FH) diagnosis and treatment. Physician feedback guided the development of an effective EHR-based CDS tool for FH.

Keywords:
CDSFHclinical decision supportelectronic health recordfamilial hypercholesterolemiagenomics

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Area of Science:

  • Cardiology
  • Medical Informatics
  • Implementation Science

Background:

  • Familial hypercholesterolemia (FH) is underdiagnosed and undertreated, leading to increased coronary heart disease risk.
  • Electronic health record (EHR)-based clinical decision support (CDS) offers a potential solution to improve FH awareness and management.

Purpose of the Study:

  • To develop and implement an EHR-based CDS tool for FH, incorporating physician perspectives.
  • To address low awareness and undertreatment of FH in clinical practice.

Main Methods:

  • Utilized an implementation science framework and user-centered design.
  • Conducted qualitative interviews, usability testing, and surveys with primary care and specialist physicians.
  • Configured CDS as best practice alerts (BPAs) and in-basket messages, deployed in silent mode.

Main Results:

  • Physician feedback highlighted themes of FH awareness, workflow integration, and CDS usability preferences.
  • 84.6% of physicians believed the CDS would improve early FH diagnosis.
  • 92.3% agreed the CDS would aid in identifying and managing FH patients.

Conclusions:

  • An EHR-based CDS tool for FH was successfully developed and refined using physician input.
  • The tool demonstrated potential for significant impact, revealing a substantial burden of FH.
  • Iterative refinement based on user feedback is crucial for effective CDS implementation.