Implementation of a CVD risk assessment algorithm in electronic health records achieved screening rates of 57.1% to 98.7% and follow-up rates of 55.9% to 72.5% across three hospital networks.
Observational (n=14,000)
Yes
Is it feasible to implement a universal CVD risk assessment algorithm into electronic health records for pregnant and postpartum patients?
Integrating a universal CVD risk assessment algorithm into electronic health records for pregnant and postpartum patients is feasible and can achieve high screening rates.
Background: Cardiovascular disease (CVD) is the leading cause of maternal mortality in the United States, accounting for over one-third of all pregnancy-related deaths. Contributing factors such as lack of recognition and delayed diagnosis of CVD are primarily due to the overlap of signs and symptoms of a normal pregnancy with those of CVD. Objectives: This study aimed to demonstrate the feasibility of introducing CVD risk assessment into clinical practice using the California Maternal Quality Care Collaborative algorithm to detect CVD during pregnancy and postpartum periods. Methods: We implemented the CVD risk assessment algorithm into electronic health records at 3 large hospital networks serving over 14,000 patients at 23 sites. We determined the percentage of pregnant and/or postpartum patients who were screened for CVD risk and the follow-up rate for patients in whom the tool recommended a follow-up assessment. Rates were stratified according to clinical site characteristics. We obtained clinician feedback regarding the feasibility and acceptability of the tool. Results: The rate of patients screened for CVD risk in the 3 hospital networks was 57.1%, 71.5%, and 98.7%. For those with a positive screen, follow-up rates were 65.8%, 72.5%, and 55.9% in the 3 networks. The rates of screening and follow-up varied based on the clinic size and specialty. Clinician-identified barriers were busy clinics, competing priorities, and the type of clinical practice. Conclusions: This innovative population-based approach for universal CVD risk assessment during pregnancy is feasible and may be a helpful strategy to decrease CVD-related maternal morbidity and mortality.
Hameed et al. (Sun,) conducted a observational in Cardiovascular disease risk in pregnancy and postpartum (n=14,000). California Maternal Quality Care Collaborative CVD risk assessment algorithm was evaluated on Percentage of pregnant and/or postpartum patients screened for CVD risk and follow-up rate for positive screens. Implementation of a CVD risk assessment algorithm in electronic health records achieved screening rates of 57.1% to 98.7% and follow-up rates of 55.9% to 72.5% across three hospital networks.