Can Electronic Provider Notification Improve Outcomes in Severe Aortic Stenosis?

A randomized trial provides a strong signal of benefit.

For patients with symptomatic severe aortic stenosis (AS), prompt receipt of guideline-recommended aortic valve replacement (AVR) can be curative. Nonetheless, approximately half of these patients do not undergo treatment within a year of diagnosis.

To increase utilization of AVR for these patients, investigators in a single academic health system tested the effectiveness of an electronic provider notification (EPN) through the electronic health record. The EPN informed clinicians of the diagnosis, provided information about prognosis with medical therapy, and made patient-specific management recommendations based on current guidelines.

During an 18-month period, 144 clinicians were randomized to EPN (they cared for 496 patients with newly di…

Reviewing Author

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Grant/Research SupportEdwards Lifesciences; Abbott Vascular; Boston Scientific; Corvia Medical; National Heart, Lung, and Blood Institute; Phillips, Inc.; St. Paul’s Hospital; V-Wave, Inc; ZOLL Medical; CathWorks, ANCORA

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Leadership Positions in Professional SocietiesSociety of Thoracic Surgeons/American College of Cardiology TVT Registry (Co-Chair, Risk Model Development Committee); Cardiovascular Research Foundation (Co-Director, TCT Annual Meeting; Co-Director, New York Valves Annual Meeting)