EHRs Help Cut Abdominal Aortic Aneurysms

A screening program for abdominal aortic aneurysms (AAAs), integrated into an EHR,  dramatically reduced the number of unscreened at-risk men by more than 50% within 15 months, according to a Kaiser Permanente study published in the Journal of Vascular Surgery. An AAA is a balloon-like bulge in the aorta, which—if ruptured—can result in death. It is estimated that more than one million Americans are living with undiagnosed AAA, according to the Society for Vascular Surgery.

Since 2005, the US Preventive Services Task Force and the American Heart Association have recommended screening in men aged 65 to 75 years with any history of smoking. Researchers examined the EHRs of 68,164 men who met these initial screening criteria. The researchers created an alert in the EHR to signal providers that the patient should be screened for AAA, and then followed these men from March 2012 to June 2013. The alerts led to a systemwide reduction of unscreened patients from 51.74% to 20.26%.

"Because abdominal aortic aneurysms are generally asymptomatic before they burst, most of the patients who have a rupture didn't even know that they had an aneurysm," says Robert J. Hye, MD, study lead author and chief of vascular surgery at Kaiser Permanente San Diego Medical Center. "That makes screening for AAA all the more vital and important."

More than 50% of ruptured AAAs result in death, according to the American Heart Association. Approximately 10,000 Americans die as a result of a ruptured of AAA each year, according to the Centers for Disease Control and Prevention.

"Because of the distinctive nature of Kaiser Permanente's health care system with its integrated network of practitioners and physicians, it is uniquely suited to perform these types of preventive health measures like aneurysm screening, colon cancer screening, and others," says Hye. "This type of program would be very hard to implement in a nonintegrated system because their practitioners don't have universal EHRs to help them monitor their patients."

Kaiser Permanente has published numerous studies about the benefits of Kaiser Permanente HealthConnect, the EHR it launched in 2004. A study published in the Journal of the American Medical Informatics Association in October 2013 found that using EHRs to automate reporting of quality measures reduces reporting time required for one measure set alone by about 50%. Another study also published that month in the Journal of the American Medical Association found that the use of EHRs in clinical settings was associated with a decrease in emergency department visits and hospitalizations for patients with diabetes.

Source: Kaiser Permanente