Streamline Provider Workflows with Clinical Decision Support

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AllianceChicago diagnoses over 1,300 pediatric hypertension cases with customized tool.

According to the Centers for Disease Control (CDC), heart disease is the leading cause of death in Americans. One in every three adults has high blood pressure (hypertension), which can lead to heart disease and stroke. High blood pressure is often called the “silent killer” because people don’t realize there is a problem until a catastrophic health event occurs.  Since hypertension usually has no signs or symptoms, it can remain undetected for years– putting people at serious risk.

With the high number of adults that have hypertension, it is no surprise that it can develop during childhood and has become a significant concern for pediatric healthcare providers. Whenever hypertension is identified, it can be treated with medication and lifestyle changes; but, it can be challenging to detect in children.

AllianceChicago, a Health Center Controlled Network with the mission of improving the personal, community and public health through innovative collaboration, wanted to focus efforts to identify the propensity for hypertension in children. The organization was concerned the diagnosis in children was often missed because of the complexity in establishing what a high blood pressure reading is for pediatric patients.

According to Nivedita Mohanty, MD and Chief Research Officer and Director of Evidence-Based Practice for AllianceChicago, “hypertension in childhood is associated with risk factors for adult cardiovascular disease and is increasing in prevalence.” Therefore, facilitating timely prevention, diagnosis and management of high blood pressure in children are urgently needed.

A diagnosis of pediatric hypertension involves algorithms that factor-in patient age, sex and measurement. These complex blood pressure interpretation standards disrupted provider workflows, leading to the concern of underdiagnosis. Historically, providers needed to step away from their EMR to consult references to interpret pediatric blood pressure normal limits. AllianceChicago concluded that customizing their EMR to accommodate the clinical decision-making support required for a pediatric hypertension diagnosis was the logical solution. The goal of the customization: allow a provider to see acceptable blood pressure ranges instantly so that a determination could be made during the patient visit and a treatment plan (if required) put into place immediately.

AllianceChicago turned to their EMR vendor to help develop a Clinical Decision Support (CDS) tool that would seamlessly integrate with their Centricity™ Practice Solution system and streamline workflows. The expertise of clinicians, informatics specialists and researchers were combined to create a responsive, customized CDS tool. The tool was systematically implemented into the organization’s EMR and quickly adopted by providers.

The AllianceChicago CDS tool had a profound, positive impact on diagnosis rates within the first year. The instrument was used across 15 health centers in 57,987 pediatric patient encounters. Nearly 1,400 children were diagnosed with elevated blood pressure.

The success of the tool prepared AllianceChicago for a significant change in guidelines for managing pediatric blood pressure that was announced the following year, in 2017. The organization was able to quickly modify its existing CDS tool and adapt to the new guidelines – within five months of the announcement.

The success of identifying hypertension in children is just one example of how AllianceChicago improves the care of populations facing chronic health conditions by creating customized tools that seamlessly integrate with their EMR. Virtual OfficeWare Healthcare Solutions (VOWHS) can do the same for your organization. To learn more about creating CDS tools that develop efficient workflows and positively impact your patients’ health, contact us at 412-424-2260.

Since its founding in 2000, VOWHS has provided a complete platform of clinical and business performance products, including Centricity Practice Management and Electronic Health Records as well as integrated auxiliary solutions to enhance the Centricity experience. In addition to product sales, VOWHS offers personalized implementation, training, support, hosting and customized programming & reports.

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