Evaluating an Electronic Health Record Intervention for Management of Heart Failure Among Veterans

Background: We studied the feasibility of using the Veteran Health Administration's electronic health record (EHR), My Health e Vet, as an educational and monitoring tool for veterans with heart failure (HF). Methods: We enrolled 120 HF patients with a mean age (±standard deviation): 64.8 ± 9.6, range: 41–91 years. There were 105 (87.5%) non-Hispanics, 15 (12.5%) Hispanics, 91 (75.8%) whites, and 20 (16.5%) blacks, and 62 (51.7%) were married. Study participants received educational material on managing their HF and were monitored on their weight and HF symptoms weekly. Surveys on My Health e Vet use and secondary outcomes including knowledge of their illness, quality of life (QoL), and self-efficacy were conducted at baseline and 26 weeks after enrollment. Results: Among the participants, 55 (45.8%) had used My Health e Vet. The number of weeks each user responded to the weekly messages by the care coordinator ranged from 1 (4%) to 26 (100%) with a median of 8. Secondary outcome data were available for 54 patients (24 users and 30 nonusers) who participated in both baseline and 26-week surveys. There was a significant improvement in QoL ( p < 0.01) among users of My Health e Vet compared with nonusers. There were no significant differences with respect to self-efficacy or HF knowledge. Use of My Health e Vet and ease in using the Health e Vet portal increased from baseline to follow-up. Conclusions: EHR-based interventions have potential for HF monitoring and case management, and may be feasible in improving QoL for patients.