Summary
Background: The 2013 American College of Cardiology / American Heart Association Guidelines for
the Treatment of Blood Cholesterol emphasize treatment based on cardiovascular risk.
But finding time in a primary care visit to manually calculate cardiovascular risk
and prescribe treatment based on risk is challenging. We developed an informatics-based
clinical decision support tool, MayoExpertAdvisor, to deliver automated cardiovascular
risk scores and guideline-based treatment recommendations based on patient-specific
data in the electronic heath record.
Objective: To assess the impact of our clinical decision support tool on the efficiency and
accuracy of clinician calculation of cardiovascular risk and its effect on the delivery
of guideline-consistent treatment recommendations.
Methods: Clinicians were asked to review the EHR records of selected patients. We evaluated
the amount of time and the number of clicks and keystrokes needed to calculate cardiovascular
risk and provide a treatment recommendation with and without our clinical decision
support tool. We also compared the treatment recommendation arrived at by clinicians
with and without the use of our tool to those recommended by the guidelines.
Results: Clinicians saved 3 minutes and 38 seconds in completing both tasks with MayoExpertAd-visor,
used 94 fewer clicks and 23 fewer key strokes, and improved accuracy from the baseline
of 60.61% to 100% for both the risk score calculation and guideline-consistent treatment
recommendation.
Conclusion: Informatics solution can greatly improve the efficiency and accuracy of individualized
treatment recommendations and have the potential to increase guideline compliance.
Keywords
Clinical decision support system - ambulatory care information systems - testing and
evaluation of health information technology - electronic health records - knowledge
delivery - knowledge management
