J Clin Outcomes Manage
Impact of an EMR clinical decision support tool on lipid management
Kelly E, Wasser T, Fraga JD, Scheirer JJ, Alweis RL
ABSTRACT: Objective: To determine if an electronic medical record (EMR) clinical decision support tool was effective as a method for improving the management of hyperlipidemia. Methods: Retrospective chart review in randomly selected patients aged 50 to 75 years old with lipid measurements, stratified by whether or not they had been assigned an LDL goal using the EMR tool. Changes in patientsí lipid values were assessed as follows: For the tool group (n = 100), lipid results immediately prior to setting lipid goals and the sub-sequent lipid results were used. For the no-tool group (n = 100), the first and second lipid results available in the EMR were used. Paired t tests were used to determine the impact of the tool on achieving lipid goals. Group t tests were performed to compare baseline characteristics. Results: Patients who were not at their LDL goal at baseline had significant reductions in both total cholesterol and LDL levels, regardless of tool use (both p < 0.05) and improvement in achievement of LDL goals (72% to 77% in no-tool group; 41% to 57% in tool group; p < 0.001). 50.0% (no-tool group) and 40.7% (tool group) of patients not at goal initially achieved target LDL, but the difference was nonsignificant (p = 0.413). Conclusions: Use of the EMR tool did not lead to an improvement in achieving lipid goals as compared with not using the tool. Since this echoes other recent findings, the cost and effectiveness of this tool should be re-evaluated
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