VA Hospital Cardiac Electronic Clinical Guideline Reminder Outcomes

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Approximately 16 million American adults suffer from Coronary Heart Disease (CHD); it is the number one single cause of death in the United States. Coronary Artery Bypass Graft (CABG), a procedure used to treat CHD, is a type of heart surgery which reroutes blood around clogged arteries to improve perfusion to the heart. Post-CABG patients are at an obvious risk of recurrence and thus need optimal secondary prevention after CABG in order to minimize future cardiac risk. Post-CABG care often includes the use of antihypertensive (AH) and lipid lowering (LL) medications to prevent further cardiac health concerns. Through controlled clinical trials, these two classes of medications have been proven to be effective in terms of secondary prevention of negative cardiac outcomes after CABG. Appropriate medication management of LL and AH therapy, through the use of clinical reminders, may impact the survival of post-CABG veterans. The VA has developed a comprehensive Computerized Patient Record System (CPRS) that allows access to patient notes, lab values, medication orders and visit dates. Included in CPRS is a tool called Clinical Reminders, which is designed to prompt physicians to act on deficiencies in patient management. For example when a patient is suffering from hypertension, the computer prompts the physician to begin lifestyle counseling and therapeutic intervention.