Impact Of An Automated Titration Algorithm On Battery Longevity In An Implantable Neurostimulation System For Treatment Of Chronic Heart Failure
HFSA ePoster Library. Libbus I. 09/10/21; 343412; 184
Imad Libbus
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Abstract
Discussion Forum (0)
Intro: As healthcare payment models continue to shift from fee-for-service to pay-for-performance, adequate tools to measure & manage population health will be critical. Heart failure (HF) remains a prevalent & costly chronic condition that has been difficult to manage on a population basis. Guideline-directed optimal medical therapy (OMT) improves HF outcomes, but significant limitations exist in assessing & improving physician/patient compliance with guideline-directed therapy in real world clinical practice.
Hypothesis: Creating an objective scoring system for HF OMT & integrating it into the EMR can benchmark current medical therapy in HF patients & identify gaps in guideline-directed care.
Methods: A small committee within a 100-physician cardiology practice worked to adapt a proposed HF OMT score published in a JACC:HF editorial to meet updated guidelines & specific practice goals. The different guideline-directed HF medications were assigned scores to be combined to a total HF OMT score for a specific patient. The score was integrated into EMR to calculate prospectively for all patient encounters in which there was a history of LVEF less than or equal to 40% or diagnosis of systolic heart failure without LVEF. The treating physician/APP was not alerted to the calculated score in order to truly assess the baseline use of OMT in HF pts. Results: The HF OMT score was calculated for 1,201 pts at the time of a physician/APP encounter over a one-month period. The average score for all visits was 2.8. Evaluation by medication class & dose reveals significant underutilization of MRA and SGLT2i in HF patients in our practice.
Conclusion: Active management & optimization of guideline driven OMT in HF pts across a population will be critical to improving outcomes & succeeding in the evolving pay-for-performance environment. Long term use of a standardized HF OMT score can identify gaps in care for specific medications, by specific physician/APPs, or related to specific patient factors (race/ethnicity, insurance status, gender). Additionally this score can be used to measure the success of future interventions targeting improved compliance with guideline-directed therapy.
Hypothesis: Creating an objective scoring system for HF OMT & integrating it into the EMR can benchmark current medical therapy in HF patients & identify gaps in guideline-directed care.
Methods: A small committee within a 100-physician cardiology practice worked to adapt a proposed HF OMT score published in a JACC:HF editorial to meet updated guidelines & specific practice goals. The different guideline-directed HF medications were assigned scores to be combined to a total HF OMT score for a specific patient. The score was integrated into EMR to calculate prospectively for all patient encounters in which there was a history of LVEF less than or equal to 40% or diagnosis of systolic heart failure without LVEF. The treating physician/APP was not alerted to the calculated score in order to truly assess the baseline use of OMT in HF pts. Results: The HF OMT score was calculated for 1,201 pts at the time of a physician/APP encounter over a one-month period. The average score for all visits was 2.8. Evaluation by medication class & dose reveals significant underutilization of MRA and SGLT2i in HF patients in our practice.
Conclusion: Active management & optimization of guideline driven OMT in HF pts across a population will be critical to improving outcomes & succeeding in the evolving pay-for-performance environment. Long term use of a standardized HF OMT score can identify gaps in care for specific medications, by specific physician/APPs, or related to specific patient factors (race/ethnicity, insurance status, gender). Additionally this score can be used to measure the success of future interventions targeting improved compliance with guideline-directed therapy.
Intro: As healthcare payment models continue to shift from fee-for-service to pay-for-performance, adequate tools to measure & manage population health will be critical. Heart failure (HF) remains a prevalent & costly chronic condition that has been difficult to manage on a population basis. Guideline-directed optimal medical therapy (OMT) improves HF outcomes, but significant limitations exist in assessing & improving physician/patient compliance with guideline-directed therapy in real world clinical practice.
Hypothesis: Creating an objective scoring system for HF OMT & integrating it into the EMR can benchmark current medical therapy in HF patients & identify gaps in guideline-directed care.
Methods: A small committee within a 100-physician cardiology practice worked to adapt a proposed HF OMT score published in a JACC:HF editorial to meet updated guidelines & specific practice goals. The different guideline-directed HF medications were assigned scores to be combined to a total HF OMT score for a specific patient. The score was integrated into EMR to calculate prospectively for all patient encounters in which there was a history of LVEF less than or equal to 40% or diagnosis of systolic heart failure without LVEF. The treating physician/APP was not alerted to the calculated score in order to truly assess the baseline use of OMT in HF pts. Results: The HF OMT score was calculated for 1,201 pts at the time of a physician/APP encounter over a one-month period. The average score for all visits was 2.8. Evaluation by medication class & dose reveals significant underutilization of MRA and SGLT2i in HF patients in our practice.
Conclusion: Active management & optimization of guideline driven OMT in HF pts across a population will be critical to improving outcomes & succeeding in the evolving pay-for-performance environment. Long term use of a standardized HF OMT score can identify gaps in care for specific medications, by specific physician/APPs, or related to specific patient factors (race/ethnicity, insurance status, gender). Additionally this score can be used to measure the success of future interventions targeting improved compliance with guideline-directed therapy.
Hypothesis: Creating an objective scoring system for HF OMT & integrating it into the EMR can benchmark current medical therapy in HF patients & identify gaps in guideline-directed care.
Methods: A small committee within a 100-physician cardiology practice worked to adapt a proposed HF OMT score published in a JACC:HF editorial to meet updated guidelines & specific practice goals. The different guideline-directed HF medications were assigned scores to be combined to a total HF OMT score for a specific patient. The score was integrated into EMR to calculate prospectively for all patient encounters in which there was a history of LVEF less than or equal to 40% or diagnosis of systolic heart failure without LVEF. The treating physician/APP was not alerted to the calculated score in order to truly assess the baseline use of OMT in HF pts. Results: The HF OMT score was calculated for 1,201 pts at the time of a physician/APP encounter over a one-month period. The average score for all visits was 2.8. Evaluation by medication class & dose reveals significant underutilization of MRA and SGLT2i in HF patients in our practice.
Conclusion: Active management & optimization of guideline driven OMT in HF pts across a population will be critical to improving outcomes & succeeding in the evolving pay-for-performance environment. Long term use of a standardized HF OMT score can identify gaps in care for specific medications, by specific physician/APPs, or related to specific patient factors (race/ethnicity, insurance status, gender). Additionally this score can be used to measure the success of future interventions targeting improved compliance with guideline-directed therapy.
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