A screening program for abdominal aortic aneurysms, integrated into an electronic health record, dramatically reduced the number of unscreened at-risk men by more than 50 percent within 15 months, according to a Kaiser Permanente study published today in the Journal of Vascular Surgery. An abdominal aortic aneurysm 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 U.S. 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 the 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 system-wide reduction of unscreened patients from 51.74 percent to 20.26 percent.
"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," said Robert J. Hye, MD, study lead author and chief of vascular surgery, Kaiser Permanente San Diego Medical Center. "That makes screening for AAA all the more vital and important."
More than 50 percent 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," said Dr. Hye. "This type of program would be very hard to implement in a non-integrated system because their practitioners don't have universal EHRs to help them monitor their patients."
- Robert J. Hye, Andrea E. Smith, Gary H. Wong, Southida S. Vansomphone, Ronald D. Scott, Michael H. Kanter. Leveraging the electronic medical record to implement an abdominal aortic aneurysm screening program. Journal of Vascular Surgery, 2014; DOI: 10.1016/j.jvs.2013.12.016
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