Exploring Which EHR Interventions Improve Heart Failure Hospitalization Outcomes Across 10 Hospitals

Heart failure (HF) remains a major cause of mortality and hospitalization despite advances in guideline-directed medical therapy (GDMT). Electronic health record (EHR)-based clinical decision support tools may improve care delivery, but their impact on outcomes remains ill-defined.

As part of a system-wide HF quality improvement initiative, we evaluated 2 EHR interventions: an evidence-based HF admission order set promoting early diuresis and GDMT optimization, and a templated HF documentation tool (HFNOTE) designed to capture clinical complexity.

We analyzed 4,865 HF hospitalizations across 10 hospitals between December 2024 and June 2025. Overall risk-adjusted mortality index was 0.83 and 30-day readmission index was 1.07. Both admission order set and HFNOTE use were associated with lower mortality index compared to nonuse. Readmission indices were similar across groups.

Targeted EHR interventions were associated with lower risk-adjusted inpatient mortality with a limited impact on 30-day readmissions, warranting further analyses to determine causal effects.