Electronic health records and outpatient cardiovascular disease care delivery: Insights from the American College of Cardiology’s PINNACLE India Quality Improvement Program (PIQIP)
Background: There has been a push toward implementation of electronic health records (EHRs) in federally-funded hospitals under the current policies initiated by the Indian government, with a lack of evidence supporting their adoption. We analyzed data from the American College of Cardiology’s PINNA...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018-09-01
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| Series: | Indian Heart Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483217309847 |
| _version_ | 1818749944818827264 |
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| author | Ankur Kalra Deepak L. Bhatt Jessica Wei Karen L. Anderson Stefan Rykowski Prafulla G. Kerkar Ganesh Kumar Thomas M. Maddox William J. Oetgen Salim S. Virani |
| author_facet | Ankur Kalra Deepak L. Bhatt Jessica Wei Karen L. Anderson Stefan Rykowski Prafulla G. Kerkar Ganesh Kumar Thomas M. Maddox William J. Oetgen Salim S. Virani |
| author_sort | Ankur Kalra |
| collection | DOAJ |
| description | Background: There has been a push toward implementation of electronic health records (EHRs) in federally-funded hospitals under the current policies initiated by the Indian government, with a lack of evidence supporting their adoption. We analyzed data from the American College of Cardiology’s PINNACLE (Practice Innovation and Clinical Excellence) India Quality Improvement Program (PIQIP) to evaluate the association between EHR use and quality of cardiovascular disease care in India. Methods and Results: Between 2011–2016, we collected data on performance measures for patients with coronary artery disease (CAD), heart failure (HF) and atrial fibrillation (AF) among 17 participating practices in PIQIP. There were 19,035 patients with CAD, 9,373 patients with HF, and 1,127 patients with AF. Documentation of co-morbidity burden in patients with CAD was lower among practices with EHR—hypertension (49.8% vs. 52.1%, p = 0.003), diabetes (34.9% vs. 38.3%, p < 0.001), and hyperlipidemia (0.2 vs. 3.9%, p < 0.001). On the contrary, documentation of medication prescription was higher in CAD patients seen at practices with EHR—aspirin (63.2% vs. 17.8%, p < 0.001), clopidogrel (41.7% vs. 27.4%, p < 0.001), beta-blockers (61.4% vs. 9.8%, p < 0.001), and ACE-i or ARBs (53.9% vs. 16.4%, p < 0.001). Similarly, documentation of receipt of beta-blockers (43.8% vs. 10.7%, p < 0.001), ACE-i or ARBs (40.8% vs. 16.1%, p < 0.001), and beta-blockers + ACE-i or ARBs (36.4% vs. 3.6%, p < 0.001) was also significantly higher in patients with HF seen at practices with EHR. Among patients with AF, documentation of oral anticoagulation use was significantly higher among EHR practices—warfarin (42.5% vs. 26.1%, p < 0.001). Conclusions: Documentation of receipt of guideline-directed medical therapy in CAD, HF, and AF was significantly higher in practices with EHRs in India compared with sites without EHRs. Our findings shed a spotlight on the value of EHRs in future health care policy-making in India with regard to widespread adoption of EHRs in primary and advanced specialty care settings across public and private sectors. Keywords: Electronic health record, Cardiovascular care, India, Quality improvement, American College of Cardiology |
| first_indexed | 2024-12-18T04:11:50Z |
| format | Article |
| id | doaj.art-40752149697c407f91e5c2d5d58f3283 |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-12-18T04:11:50Z |
| publishDate | 2018-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-40752149697c407f91e5c2d5d58f32832022-12-21T21:21:27ZengElsevierIndian Heart Journal0019-48322018-09-01705750752Electronic health records and outpatient cardiovascular disease care delivery: Insights from the American College of Cardiology’s PINNACLE India Quality Improvement Program (PIQIP)Ankur Kalra0Deepak L. Bhatt1Jessica Wei2Karen L. Anderson3Stefan Rykowski4Prafulla G. Kerkar5Ganesh Kumar6Thomas M. Maddox7William J. Oetgen8Salim S. Virani9Division of Cardiology, Department of Medicine, Kalra Hospital SRCNC (Sri Ram Cardio-thoracic and Neurosciences Centre) Pvt. Ltd., New Delhi, India; Division of Cardiovascular Medicine, Department of Medicine, Case Western Reserve University School of Medicine, United StatesBrigham and Women’s Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA, United StatesAmerican College of Cardiology Foundation, Washington, DC, United StatesAmerican College of Cardiology Foundation, Washington, DC, United StatesAmerican College of Cardiology Foundation, Washington, DC, United StatesKing Edward VII Memorial Hospital and Seth G S Medical College, Mumbai, India; Asian Heart Institute and Research Center, Mumbai, IndiaL H Hiranandani Hospital, Mumbai, IndiaVeterans Affairs Eastern Colorado Health Care System, United States; University of Colorado School of Medicine, United States; Colorado Cardiovascular Outcomes Research Consortium, Denver, CO, United StatesAmerican College of Cardiology Foundation, Washington, DC, United StatesHouston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, United States; Health Policy, Quality & Informatics Program, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research and Development Center for Innovations, United States; Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, United States; Corresponding author at: Health Services Research and Development (152), Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd., Houston, TX 77030, United States.Background: There has been a push toward implementation of electronic health records (EHRs) in federally-funded hospitals under the current policies initiated by the Indian government, with a lack of evidence supporting their adoption. We analyzed data from the American College of Cardiology’s PINNACLE (Practice Innovation and Clinical Excellence) India Quality Improvement Program (PIQIP) to evaluate the association between EHR use and quality of cardiovascular disease care in India. Methods and Results: Between 2011–2016, we collected data on performance measures for patients with coronary artery disease (CAD), heart failure (HF) and atrial fibrillation (AF) among 17 participating practices in PIQIP. There were 19,035 patients with CAD, 9,373 patients with HF, and 1,127 patients with AF. Documentation of co-morbidity burden in patients with CAD was lower among practices with EHR—hypertension (49.8% vs. 52.1%, p = 0.003), diabetes (34.9% vs. 38.3%, p < 0.001), and hyperlipidemia (0.2 vs. 3.9%, p < 0.001). On the contrary, documentation of medication prescription was higher in CAD patients seen at practices with EHR—aspirin (63.2% vs. 17.8%, p < 0.001), clopidogrel (41.7% vs. 27.4%, p < 0.001), beta-blockers (61.4% vs. 9.8%, p < 0.001), and ACE-i or ARBs (53.9% vs. 16.4%, p < 0.001). Similarly, documentation of receipt of beta-blockers (43.8% vs. 10.7%, p < 0.001), ACE-i or ARBs (40.8% vs. 16.1%, p < 0.001), and beta-blockers + ACE-i or ARBs (36.4% vs. 3.6%, p < 0.001) was also significantly higher in patients with HF seen at practices with EHR. Among patients with AF, documentation of oral anticoagulation use was significantly higher among EHR practices—warfarin (42.5% vs. 26.1%, p < 0.001). Conclusions: Documentation of receipt of guideline-directed medical therapy in CAD, HF, and AF was significantly higher in practices with EHRs in India compared with sites without EHRs. Our findings shed a spotlight on the value of EHRs in future health care policy-making in India with regard to widespread adoption of EHRs in primary and advanced specialty care settings across public and private sectors. Keywords: Electronic health record, Cardiovascular care, India, Quality improvement, American College of Cardiologyhttp://www.sciencedirect.com/science/article/pii/S0019483217309847 |
| spellingShingle | Ankur Kalra Deepak L. Bhatt Jessica Wei Karen L. Anderson Stefan Rykowski Prafulla G. Kerkar Ganesh Kumar Thomas M. Maddox William J. Oetgen Salim S. Virani Electronic health records and outpatient cardiovascular disease care delivery: Insights from the American College of Cardiology’s PINNACLE India Quality Improvement Program (PIQIP) Indian Heart Journal |
| title | Electronic health records and outpatient cardiovascular disease care delivery: Insights from the American College of Cardiology’s PINNACLE India Quality Improvement Program (PIQIP) |
| title_full | Electronic health records and outpatient cardiovascular disease care delivery: Insights from the American College of Cardiology’s PINNACLE India Quality Improvement Program (PIQIP) |
| title_fullStr | Electronic health records and outpatient cardiovascular disease care delivery: Insights from the American College of Cardiology’s PINNACLE India Quality Improvement Program (PIQIP) |
| title_full_unstemmed | Electronic health records and outpatient cardiovascular disease care delivery: Insights from the American College of Cardiology’s PINNACLE India Quality Improvement Program (PIQIP) |
| title_short | Electronic health records and outpatient cardiovascular disease care delivery: Insights from the American College of Cardiology’s PINNACLE India Quality Improvement Program (PIQIP) |
| title_sort | electronic health records and outpatient cardiovascular disease care delivery insights from the american college of cardiology s pinnacle india quality improvement program piqip |
| url | http://www.sciencedirect.com/science/article/pii/S0019483217309847 |
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