TY - JOUR
T1 - Automatic evaluation of the adherence to recommendations for managing heart failure from the electronic health records
T2 - The EXEMED tool
AU - Muñoz Velandia, Oscar Mauricio
AU - García, Ángel Alberto
AU - Bustamante, Álvaro Andrés
AU - Pomares-Quimbaya, Alexandra
AU - González, Rafael A.
AU - Sierra, Alejandro
AU - Daza, Julián Camilo
AU - Bohórquez, Wilson Ricardo
N1 - Publisher Copyright:
© 2018 Sociedad Colombiana de Cardiología y Cirugía Cardiovascular
PY - 2018/9/1
Y1 - 2018/9/1
N2 - 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.
AB - 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.
KW - Clinical practice guidelines
KW - Electronic medical records
KW - Implementation
KW - Implementación
KW - Guías de práctica clínica
KW - Historias clínicas electrónicas
UR - http://www.scopus.com/inward/record.url?scp=85048243414&partnerID=8YFLogxK
U2 - 10.1016/j.rccar.2018.01.005
DO - 10.1016/j.rccar.2018.01.005
M3 - Article
AN - SCOPUS:85048243414
SN - 0120-5633
VL - 25
SP - 321
EP - 326
JO - Revista Colombiana de Cardiologia
JF - Revista Colombiana de Cardiologia
IS - 5
ER -