Related Experiment Video
Updated: Sep 19, 2026

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Enhancing Cardiac Rehabilitation Referral at Discharge Using EHR-Based Decision Support for Guideline-Eligible
Mohanad Albayyaa1, Shiva Gollapally Krishna1, Qamar Othman Abdullah2
1Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas, USA.
Background:
Cardiac rehabilitation (CR) is a guideline-recommended therapy that improves outcomes in cardiovascular disease, yet referral at hospital discharge remains suboptimal.
Project Rationale:
Variability in discharge workflows and inconsistent use of standardized referrals contributed to missed CR referrals among eligible patients.
Project Summary:
We implemented an electronic health record (EHR)-based best practice advisory within the Epic EHR system to prompt CR referral or documentation of nonreferral reasons for guideline-eligible cardiovascular patients. A retrospective quality improvement study compared preimplementation (February 1, 2022-January 31, 2024) and postimplementation (February 1, 2024-January 31, 2026) cohorts (N = 21,294). Outcomes assessed included CR referral orders, documentation of referral activity, and CR-related activity. CR referral rates increased from 45.3% to 86.7% after best practice advisory implementation.
Take-Home Messages:
EHR-based decision support improved CR referral rates among guideline-eligible patients by integrating referral prompts into discharge workflows. Continued optimization of provider engagement and workflow integration may further improve referral completion.
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