Association of health information technology-driven multidisciplinary approaches with low-density lipoprotein cholesterol target achievement in patients with an acute coronary syndrome

Figures

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  Fig. 1. The working algorithm of health information technology (HIT). The HIT system screens patients with discharge diagnosis of ACS who do not achieve their LDL-C goal and enrolls them into the system, after which high-intensity statins and periodic laboratory data follow-up are initiated at both the provider and system level. In addition, the system offers multidisciplinary care, including pharmaceutical consultations to address potential statin side effects, low-fat diet suggestions, exercise recommendations, and smoking cessation support. At the patient level, the system provides outreach services through various platforms such as messaging apps, video call, and combined care with family members.

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  Fig. 2. Patient journey of health information technology (HIT) over 12 months period. The intervention from the HIT is categorized into three main aspects: decision-making support, patient engagement, and database monitoring. The period over 12 months is divided into three phases: index hospitalization, post-acute phase (1 month after discharge), and reassessment phase (3–12 months). During index hospitalization, the HIT system focuses on high-intensity statins prescription, patient engagement and education, and comprehensive management of comorbidities. In the post-acute phase, the emphasis changes to monitor drug adherence and statin intolerance. Finally, during the reassessment phase, the HIT system efforts on tracking lipid profiles, titration of optimal medical therapy, reassessing patient compliance, and activating multidisciplinary care at appropriate timing and situations. ACS, Acute coronary syndrome; ALT, Alanine transaminase; AST, Aspartate transaminase; CPK, Creatine phosphokinase; HIT, Health information technology; LDL-C, Low-density lipoprotein cholesterol.

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  Fig. 3. Patient disposition. ACS, Acute coronary syndrome.

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  Fig. 4. Primary outcome after implementing health information technology (HIT). ent rate is percentage and the p-value between each groups was analyzed using one-way ANOVA. B. Data for serum LDL-C level is median values with interquartile range and was analyzed using Kruskal-Wallis test. Statistical significance was defined as a p-value < 0.05.