Automatic evaluation of the adherence to recommendations for managing heart failure from the electronic health records: The EXEMED tool

Oscar Mauricio Muñoz Velandia, Ángel Alberto García, Álvaro Andrés Bustamante, Alexandra Pomares-Quimbaya, Rafael A. González, Alejandro Sierra, Julián Camilo Daza, Wilson Ricardo Bohórquez

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: The implementation of clinical practice guidelines is limited due to the lack of tools to carry out audits and provide feedback to the health professionals. In this study, an evaluation is performed using the automated (EXEMED) tool in order to assess the adherence to clinical practice guidelines from the information entered in the electronic health records. Methods: The adherence to 5 recommendations contained in the heart failure clinical practice guidelines was evaluated in a group of 35 patients admitted to the Hospital Universitario San Ignacio between January 2016 and March 2016. The automated EXEMED tool was used to assess this, by comparing the results obtained with the evaluation carried out by an independent medical committee. The kappa coefficient was used to determine the agreement between the two methods. Results: The adherence to the different recommendations varied between 0%, for the determination of the abdominal circumference, up to 97%, for the use of beta-blockers at discharge. Percentage agreement between the two evaluation methods was above 90% for all the recommendations. The kappa for the different recommendations was 0.78 (95% CI; 0.62-0.95) and 0.64 (0.48-0.80). The evaluation time was reduced from 20 minutes to 2 minutes with the use of the EXEMED tool. Conclusions: EXEMED is a valid and effective tool in the evaluation of adherence to clinical practice guidelines. Further studies are required to assess the impact of its used associated with feedback to the clinicians, in the long-term outcomes of patients with heart failure.

Translated title of the contributionEvaluación automática de la adherencia a las recomendaciones de manejo en falla cardiaca a partir de las historias clínicas electrónicas: herramienta EXEMED
Original languageEnglish
Pages (from-to)321-326
Number of pages6
JournalRevista Colombiana de Cardiologia
Volume25
Issue number5
DOIs
StatePublished - 01 Sep 2018

Keywords

  • Clinical practice guidelines
  • Electronic medical records
  • Implementation

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