Innovative Informatics Approaches for Peripheral Artery Disease: Current State and Provider Survey of Strategies for Improving Guideline-Based Care

摘要: Abstract Objective To quantify compliance with guideline recommendations for secondary prevention in peripheral artery disease (PAD) using natural language processing (NLP) tools deployed to an electronic health record (EHR) and investigate provider opinions regarding clinical decision support (CDS) promote improved implementation of these strategies. Patients Methods Natural was used automated identification moderate severe PAD cases from narrative notes EHR patients seen consultation May 13, 2015, July 27, 2015. Guideline-recommended strategies assessed within 6 months diagnosis included therapy statins, antiplatelet agents, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, smoking abstention. Subsequently, a survey assess knowledge practice guidelines, comfort recommending strategies, potential role CDS. Results Among 73 identified by NLP, only 12 (16%) were on 4 guideline-recommended A total 207 760 (27%) providers responded the survey; 141 (68%) generalists 66 (32%) specialists. Although 183 (88%) managed PAD, 51 (25%) indicated they uncomfortable doing so; 138 (67%) favored development CDS system tailored their 146 (71%) agreed that EHR-derived mortality risk score calculator would be helpful. Conclusion can identify EHRs quality metric studies. Findings this pilot study demonstrate gaps application PAD. Providers strongly systems assist them providing evidence-based care at point care.