Best Practice Alerts Up Screening for Abdominal Aortic Aneurysm
Electronic medical record-based system increases screening rate, decreases proportion of unscreened
TUESDAY, Feb. 18, 2014 (HealthDay News) -- An abdominal aortic aneurysm (AAA) screening program using electronic medical records (EMR) can increase AAA screening, according to research published online Feb. 10 in the Journal of Vascular Surgery.
Robert J. Hye, M.D., from Southern California Kaiser Permanente in San Diego, and colleagues describe the design and implementation of an AAA screening program using EMRs. Men aged 65 to 75 years, with any history of smoking, were targeted for screening between March 2012 and June 2013. Patients with abdominal imaging studies within 10 years that would have diagnosed an AAA were excluded after electronic review of medical records. Best practice alerts (BPAs) were created in the EMR to prompt office staff and providers to order aortic ultrasound for appropriate patients.
In a population of 3.6 million patients, the researchers found that 55,610 patients initially met screening criteria, and 48.26 percent had undergone previous abdominal imaging studies and were excluded from BPAs. A total of 68,164 patients met screening criteria after 15 months, of whom 79.74 percent had undergone an abdominal imaging study. Consequently, after BPA activation, 27,519 patients underwent an imaging study. Seven hundred thirty-one new AAAs were diagnosed during the study period, of which 165 were over 4.0 cm in diameter. At all medical centers where BPAs were activated, screening rates increased, and there was a system-wide reduction in the percentage of unscreened patients from 51.74 to 20.26 percent.
"Further analysis is required to assess the impact of the screening program on AAA rupture rate and cost-effectiveness in our system," the authors write.