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Clinical Decision Support Tools Boost Cardio Health Communication

Oncologists, clinicians, and patients reported increased cardiovascular health awareness and care with an EHR-integrated clinical decision support tool.

A cardiovascular health clinical decision support (CDS) tool can increase awareness and communication between providers and patients, along with potentially increasing survivorship care delivery for those with breast cancer, according to a study published in JMIR Publications.

Individuals who survived breast cancer can face cardiovascular health issues, with many breast cancer survivors being more likely to die from cardiovascular disease than cancer, according to the study authors.

Researchers said implementing a CDS tool into the EHR could boost cardiovascular risk factor awareness in oncology settings and maintain or enhance cardiovascular health for survivors.

CDS tools enable prescribers to access real-time patient data, ideally resulting in enhanced patient safety and medication accuracy. CDS can also alert prescribers to prevent medication errors and additional adverse drug events from happening. Furthermore, the tools can provide relevant data to providers to prompt recommended disease management and referrals.

The research team developed the Automated Heart-Health Assessment (AH-HA) tool and the Vigor-Us mobile app for breast cancer survivors and integrated the AH-HA tool into the EHR system, while the mobile app collected the information.

The study authors assessed patient awareness of cardiovascular risk factors among 49 breast cancer survivor participants. They also looked at the usability of the EHR-embedded tool from the perspective of both the patient and 20 providers.

Prior to the study, 65 percent of survivors said they did not know their cardiovascular levels or multiple health factors and only 45 percent of survivors said they knew their cardiovascular health was at an ideal level. Over 50 percent of survivor respondents said they had ideal smoking status, but less than 50 percent knew if they had ideal blood pressure, body mass index, cholesterol level, diet, and physical activity.

Following the study, over 90 percent of survivors thought the mobile app was easy to understand, improved their understanding, and was helpful. Ninety-four percent of patients liked the mobile app overall.

Also, most survivors thought oncologists should be more open and discuss cardiovascular health during care.

Ninety percent of providers reported the tool provided useful information, 90 percent said it was effective, 100 percent said was easy to use, and 95 percent said it presented information in a useful format. Eighty-five percent of providers reported they would use the tool most or all of the time when providing survivorship care.

“Overall, our results suggest both the need for and suitability of a tailored cardiovascular health assessment tool to heighten awareness of cardiovascular health among oncology providers and breast cancer survivors,” wrote the study authors. “We present the first usability data from breast cancer survivors and oncology providers on the usability of EHR-integrated cardiovascular health assessment tools.”

Although this study focused on cardiovascular health with breast cancer survivors, the study authors said the tool could be optimized for other survivor populations who could face similar risk of cardiovascular disease. The study authors also said future testing of this EHR tool should occur in a more diverse patient setting.

“The AH-HA point-of-care EHR-based visualization tool brings together personalized cardiovascular health and contextual cancer treatment data to address potential gaps in breast cancer survivorship care,” the researchers concluded.

“Our previous SPHERE study suggested that cardiovascular health clinical decision support tools are well-received in the primary care setting. Findings from the current study suggest that oncology providers and breast cancer survivors would benefit from and value the integration of cardiovascular health clinical decision support apps in survivorship care.”

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