Table 17aSummary of the impact of health IT applications on clinical outcomes for patients with heart disease

Study, YearHealth IT ApplicationIntervention ComparedOutcomes MeasurePositive Impact*
Feldman, 200532Communication via emailHeart failure patients whose nurses received email recommendations (basic intervention) vs. heart failure patients receiving usual careKCCQ summary score adjusted (higher score = better outcome)+
KCCQ physical limitation domain score adjusted (higher score = better outcome)+
KCCQ symptom domain score (higher score = better outcome)+
Depression adjusted score (higher score = presence of depression)+
EuroQoL health-related QOL adjusted score (higher score = better outcome)+
Percent with KCCQ QOL domain score >=50+
Percent with KCCQ social limitation domain score >= 50+
KCCQ percent w/self efficacy domain score >=50+
Heart failure patients whose nurses received email recommendations and additional resources (augmented intervention) vs. heart failure patients receiving usual careKCCQ summary score Adjusted score (higher score = better outcome)+
KCCQ physical limitation domain score Adjusted score (higher score = better outcome)+
KCCQ symptom domain score (higher score = better outcome)+
Depression Adjusted score (higher score = presence of depression)+
EuroQoL health-related QOL Adjusted score (higher score = better outcome)
KCCQ percent w/QOL domain score >=50+
KCCQ percent w/social limitation domain score >= 50+
KCCQ percent w/self efficacy domain score >=50+
Jerant, 2001 40Telemonitoring systemsNurse phone calls with nurse vs. usual careMedian health care utilization+
Home telemonitoring videoconferencing vs. usual care
Jerant, 2003 248TelemedicineTelemedicine vs. usual careEmotional subscale on Minnesota Living With Heart Failure Questionnaire: mean
Physical subscale on Minnesota Living With Heart Failure Questionnaire: mean
Total score on Minnesota Living With Heart Failure Questionnaire: mean
Short Form-36 mental component score
Short Form-36 physical component score+
Telephone vs. usual careEmotional subscale on Minnesota Living With Heart Failure Questionnaire: mean0
Physical subscale on Minnesota Living With Heart Failure Questionnaire: mean
Total score on Minnesota Living With Heart Failure Questionnaire: mean
Short Form-36 mental component score+
Short Form-36 physical component score+
Kucher, 200534Clinical decision aidsComputerized alert to physician about patient’s risk of deep vein thrombosis vs. no computerized alertDeath at 30 days
Death at 90 days
Major hemorrhage at 30 days0
Minor hemorrhage at 30 days+
Mechanical prophylaxis+
Pharmacologic prophylaxis+
Deep vein thrombosis of the arms at 90 days+
Lowensteyn, 199835Information exchangeCoronary risk profile to physician vs. no profile risk to physicianTotal-C
HDL
LDL
Total-C/HDL ratio
Systolic blood pressure
Diastolic blood pressure
Body mass index
8-year coronary risk
CV age
Montgomery, 200053Clinical decision aidsCDSS and risk chart vs. usual careMean 5-year CV risk+
CV risk chart vs. usual care (chart only)Mean 5-year CV risk0
Noel, 200443Electronic medical records, telemonitoring systemsHome telemonitoring that used standard phone lines to communicate with the hospital and integrate into hospital electronic health records vs. usual home health care services and nurse case management.Bed-days-of-care+
Urgent clinic/emergency room visits+
Hba1c+
Cognitive status+
Bed-days-of-care+
HbA1c+
Cognitive status+
Poller, 2008212Telemonitoring systemsPARMA-5 computer-assisted dosage program vs. manual dosageIncidence of clinical events+
Minor bleeds+
Major bleeds+
Thrombotic events+
Deaths+
Total Events in DVT/PE group
Poller, 2008119Clinical decision aids, IT-guided disease managementComputer-assisted oral anticoagulant dosage vs. medical staff dosageTime for which International Normalized Ratio was in range+
Incidence of clinical events adjudicated+
Minor bleeds+
Major bleeds+
Thrombotic events+
Deaths+
Total events in DVT/PE group
Time for which International Normalized Ratio (INR) was in range+
Incidence of clinical events adjudicated+
Minor bleeds+
Major bleeds+
Thrombotic events+
Deaths+
Total events in DVT/PE group
Ross, 200444Electronic medical recordSPPARO to access electronic hospital records vs. standard careKCCQ self-efficacy score
Symptom stability+
QOL+
Functional status+
Clinical summary+
Physical limitations
Roumie, 200652Communication via email, education via IT, information exchangeProvider who received email message and alert vs. only emailSystolic blood pressure+
Systolic blood pressure ≤140 mmHg
Dose increased+
Drug added+
Both increased dose and drug added+
Provider who received email message, alert and patient education vs. only emailSystolic blood pressure+
Systolic blood pressure ≤140 mm Hg+
Dose increased
Drug added+
Both increased dose and drug added+
Subramanian, 200436Clinical decision aidsPhysicians care suggestions generated with electronic medical record data and symptom data from patient questionnaires within 2 weeks of scheduled outpatient visits (intervention group) vs. physicians whose suggestions were generated with EMR data alone (control group).Short Form-36: Physical Component Scale
Short Form-36: Mental Component Scale+
Scherr, 200945TelemonitoringParticipants in the intervention group received pharmacological treatment with telemedical surveillanceEvent free survival+
Tierney, 200337IT-guided disease managementEvidence-based cardiac care suggestions, approved by a panel of local cardiologists and general internists, were displayed to physicians and pharmacists as they cared for enrolled patients vs. control group where suggestions were withheldMental health Short-Form 36 subscale score0
Overall health status (Chronic heart disease questionnaire score)0
Dyspnea (Chronic heart disease questionnaire score)+
Fatigue (Chronic heart disease questionnaire score)0
Emotion (Chronic heart disease questionnaire score)
Printed note (rather than bottle labels) instructing the pharmacist to view the care suggestions in an electronic database of those suggestions vs. control group where suggestions were withheldMental health Short-Form 36 subscale score+
Overall health status (Chronic heart disease questionnaire score)0
Dyspnea (Chronic heart disease questionnaire score)+
Fatigue (Chronic heart disease questionnaire score)
Emotion (Chronic heart disease questionnaire score)+
Evidence-based cardiac care suggestions, approved by a panel of local cardiologists and general internists, were displayed to physicians and pharmacists as they cared for enrolled patients and a printed a note (rather than bottle labels) instructing the pharmacist to view the care suggestions in an electronic database of those suggestion vs. control group where suggestions were withheldMental health Short-Form 36 subscale score+
Overall health status (Chronic heart disease questionnaire score)
Dyspnea (Chronic heart disease questionnaire score)+
Fatigue (Chronic heart disease questionnaire score)0
Emotion (Chronic heart disease questionnaire score)0
Verheijden, 2004213Computer-assisted self-careWeb-based nutrition counseling and social support vs. usual careMean perceived social support0
Mean BMI+
Mean systolic blood pressure
Mean diastolic blood pressure
Mean total cholesterol
Wakefield, 200842IT-guided disease management, interactive lifestyle counselingUsual care subjects contacted their primary care nurse case manager by telephone if needed. Intervention subjects contacted their assigned study nurse via videophone if needed after discharge. Intervention nurses reinforced discharge plans, had full access to patient records and employed strategies to improve adherence with treatment plans.Minnesota Living with Heart Failure (higher score= worse QOL)
Mortality+

BMI: Body Mass Index, CDSS: Clinical Decision Support System, CV: Cardiovascular, DVT: deep vein thrombosis, E-mail: Electronic Mail, EMR: Electronic Medical Record, HbA1c: Glycated Hemoglobin, HDL: high-density lipoprotein, IT: Information Technology, KCCQ: Kansas City Cardiomyopathy Questionnaire, LDL: low-density lipoprotein, PE: Pulmonary Embolism, QOL: quality of life, SPPARO: System Providing Access to Records Online

*

“+” indicates that the intervention had a positive effect on the outcome in comparison with the control

“−” indicates that the intervention had a negative effect on the outcome in comparison with the control

“0” indicates that the intervention had no effect on the outcome in comparison with the control

Adjusted for patient, nurse, and location characteristics.

From: Results

Cover of Enabling Patient-Centered Care Through Health Information Technology
Enabling Patient-Centered Care Through Health Information Technology.
Evidence Reports/Technology Assessments, No. 206.
Finkelstein J, Knight A, Marinopoulos S, et al.

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