What does this research mean for the field?

Implementation of an EHR-based best practice advisory increases cardiac rehabilitation referral rates at discharge among guideline-eligible cardiovascular patients. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Determine whether implementing an electronic health record-based best practice advisory increases discharge referral rates to cardiac rehabilitation for guideline-eligible cardiovascular patients.

September 19, 2026JACC Case ReportsOpen Access

EHR best practice advisory increases cardiac rehabilitation referrals to ~87% among guideline-eligible patients.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular disease (n=21294). Intervention: EHR-based best practice advisory vs. Preimplementation standard workflow. Primary outcome: Cardiac rehabilitation referral rates.

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Why the study?

Cardiac rehabilitation referral at hospital discharge remains suboptimal due to variability in discharge workflows and inconsistent use of standardized referrals among eligible patients.

Does an EHR-based best practice advisory improve cardiac rehabilitation referral rates at discharge for guideline-eligible cardiovascular patients?

Population

21,294 guideline-eligible cardiovascular patients

Comparison

EHR-based best practice advisory vs preimplementation standard discharge workflow

Design

Retrospective quality improvement cohort study

Follow-up

Preimplementation: February 1, 2022-January 31, 2024; Postimplementation: February 1, 2024-January 31, 2026

Key result

Implementation of an EHR-based best practice advisory increased cardiac rehabilitation referral rates from 45.3% to 86.7% among guideline-eligible cardiovascular patients.

Authors

MAMohanad Albayyaa SKShiva Gollapally Krishna QAQamar Othman Abdullah

Discussion

Member takes

Overview

May support EHR advisories to improve CR referrals; hypothesis-generating and requires prospective outcome trials before practice change.

Key Points

Determine whether implementing an electronic health record-based best practice advisory increases discharge referral rates to cardiac rehabilitation for guideline-eligible cardiovascular patients.
Retrospective quality improvement study (N = 21,294) comparing preimplementation (February 1, 2022–January 31, 2024) and postimplementation (February 1, 2024–January 31, 2026) cohorts.
Integrated an electronic health record best practice advisory in Epic to prompt clinicians to place a cardiac rehabilitation referral order or document a reason for nonreferral at hospital discharge.
Cardiac rehabilitation referral rates increased from 45.3% in the preimplementation period to 86.7% following advisory deployment.

Study Design

Type

Cohort (n=21,294)

Structured PICO

Does an EHR-based best practice advisory improve cardiac rehabilitation referral rates at discharge for guideline-eligible cardiovascular patients?

Population

21,294 guideline-eligible cardiovascular patients evaluated in a retrospective pre- and post-implementation quality improvement study.

Exposure

Electronic health record (EHR)-based best practice advisory within the Epic EHR system to prompt cardiac rehabilitation referral or documentation of nonreferral reasons at discharge

Comparator

Preimplementation cohort (standard discharge workflow without the advisory)

Outcome

Cardiac rehabilitation referral rates (including referral orders, documentation of referral activity, and CR-related activity)

Main Result

Absolute Event Rate: 86.7% vs 45.3%

Implementing an EHR-based best practice advisory integrated into discharge workflows substantially increases cardiac rehabilitation referral rates among guideline-eligible patients.

Cite This Study

Albayyaa et al. (2026) conducted a cohort in Cardiovascular disease (n=21,294). EHR-based best practice advisory vs. Preimplementation standard workflow was evaluated on Cardiac rehabilitation referral rates. Implementation of an EHR-based best practice advisory increased cardiac rehabilitation referral rates from 45.3% to 86.7% among guideline-eligible cardiovascular patients.

synapsesocial.com/papers/6aae47640c69660b71ecc646 https://doi.org/10.1016/j.jaccas.2026.110346

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September 19, 2026JACC Case ReportsOpen Access

EHR best practice advisory increases cardiac rehabilitation referrals to ~87% among guideline-eligible patients.

View Full Paper

Ask AI

Bookmark

Why the study?

Cardiac rehabilitation referral at hospital discharge remains suboptimal due to variability in discharge workflows and inconsistent use of standardized referrals among eligible patients.

Does an EHR-based best practice advisory improve cardiac rehabilitation referral rates at discharge for guideline-eligible cardiovascular patients?

Population

21,294 guideline-eligible cardiovascular patients

Comparison

EHR-based best practice advisory vs preimplementation standard discharge workflow

Design

Retrospective quality improvement cohort study

Follow-up

Preimplementation: February 1, 2022-January 31, 2024; Postimplementation: February 1, 2024-January 31, 2026

Key result

Implementation of an EHR-based best practice advisory increased cardiac rehabilitation referral rates from 45.3% to 86.7% among guideline-eligible cardiovascular patients.

Authors

MAMohanad Albayyaa SKShiva Gollapally Krishna QAQamar Othman Abdullah

Discussion

Member takes

Overview

May support EHR advisories to improve CR referrals; hypothesis-generating and requires prospective outcome trials before practice change.

Key Points

Determine whether implementing an electronic health record-based best practice advisory increases discharge referral rates to cardiac rehabilitation for guideline-eligible cardiovascular patients.
Retrospective quality improvement study (N = 21,294) comparing preimplementation (February 1, 2022–January 31, 2024) and postimplementation (February 1, 2024–January 31, 2026) cohorts.
Integrated an electronic health record best practice advisory in Epic to prompt clinicians to place a cardiac rehabilitation referral order or document a reason for nonreferral at hospital discharge.
Cardiac rehabilitation referral rates increased from 45.3% in the preimplementation period to 86.7% following advisory deployment.

Study Design

Type

Cohort (n=21,294)

Structured PICO

Does an EHR-based best practice advisory improve cardiac rehabilitation referral rates at discharge for guideline-eligible cardiovascular patients?

Population

21,294 guideline-eligible cardiovascular patients evaluated in a retrospective pre- and post-implementation quality improvement study.

Exposure

Electronic health record (EHR)-based best practice advisory within the Epic EHR system to prompt cardiac rehabilitation referral or documentation of nonreferral reasons at discharge

Comparator

Preimplementation cohort (standard discharge workflow without the advisory)

Outcome

Cardiac rehabilitation referral rates (including referral orders, documentation of referral activity, and CR-related activity)

Main Result

Absolute Event Rate: 86.7% vs 45.3%

Implementing an EHR-based best practice advisory integrated into discharge workflows substantially increases cardiac rehabilitation referral rates among guideline-eligible patients.

Cite This Study

synapsesocial.com/papers/6aae47640c69660b71ecc646 https://doi.org/10.1016/j.jaccas.2026.110346

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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