Cardiologist perceptions on automated alerts and messages to improve heart failure care

Electronic health record (EHR)-embedded tools are known to improve prescribing of guideline-directed medical therapy (GDMT) for patients with heart failure. However, physicians may perceive EHR tools to be unhelpful and be hesitant to implement these in their practice.

The BETTER CARE-HF trial (NCT05275920) ran from April 28, 2022 to October 26, 2022 at NYU Langone Health outpatient clinics being seen by 180 cardiologists. The trial compared the effectiveness of an Alert during visits, Messages between visits, or usual care with the primary outcome of MRA prescribing. In this study, we sent surveys via electronic mail to cardiologists who either received an Alert or a Message during BETTER CARE-HF (60 cardiologists per survey).

Of the 120 cardiologists who were sent the survey, response rate was 27% in the Alert group and 33% in the Message group. A majority of respondents in both the alert and message groups agreed that EHR tools were easy to use (Alert 79%; Message 69%), served as a reminder to prescribe therapy (Alert 77%; Message 77%;), and that the underlying evidence (Alert 86%; Message 62%) and clinical information (Alert 86%; Message 69%) were trustworthy. Overall, 54% agreed with continued use of the Alert, while 31% agreed with continued use of the Message.

Cardiologists perceived the EHR tools to be easy to use, helpful, and improve the overall management of their patients with heart failure.