Spotting Primary Aldosteronism Using Electronic Health Records

Core Concepts

Effective use of electronic health records can significantly improve primary aldosteronism screening rates, leading to better patient outcomes.

Abstract

Overview

Primary aldosteronism (PA) is a common yet often overlooked cause of secondary hypertension. A study conducted by Adina F. Turcu and her team at the University of Michigan Health aimed to improve PA screening rates using a best-practice advisory (BPA) integrated into the electronic health record system.

Key Highlights

• Only 4% of at-risk patients receive recommended PA screening.
• Turcu's team developed a BPA to identify high-risk patients for PA screening.
• The BPA led to a significant increase in PA screening rates, especially among primary care physicians.
• Over 14,000 unique candidates for PA screening were identified, with various risk factors.
• Physician specialty influenced the utilization of the BPA, with internists and family medicine physicians leading screening orders.
• Patients who underwent screening were more likely to be women, Black, and younger than 35 years.
• Noninterruptive BPAs integrated into primary care workflows show promise in improving PA awareness and diagnosis.

Study Details

• 15-month quality improvement study conducted in 2023.
• Identified candidates had treatment-resistant hypertension, hypokalemia, young age, or adrenal nodules.
• 14% of candidates received orders for PA screening, with 70.5% completing the screening.
• 17.4% of screened patients had positive results.

Stats

48.1% of candidates had treatment-resistant hypertension.
43.5% exhibited hypokalemia.
10.5% were younger than 35 years.
3.1% had adrenal nodules.
14% of candidates received orders for PA screening.
70.5% completed the recommended screening.
17.4% received positive screening results.

Quotes

"Although we were hoping for broader uptake of this EHR-embedded BPA, we were delighted to see an increase in PA screening rates..." - Adina F. Turcu
"Primary hyperaldosteronism is a condition that can be treated surgically and has increased long term cardiovascular consequences if not identified." - Kaniksha Desai

Key Insights Distilled From

Spotting Primary Aldosteronism Using the EHR

by Meg at www.medscape.com 01-18-2024

https://www.medscape.com/viewarticle/ehr-tool-enhances-primary-aldosteronism-screening-2024a10001gg

Deeper Inquiries

How can healthcare systems encourage broader adoption of EHR-integrated tools like BPAs for improved patient care?

Healthcare systems can encourage broader adoption of EHR-integrated tools like Best Practice Advisories (BPAs) by providing comprehensive training and education to healthcare providers on the benefits and functionalities of these tools. It is essential to involve clinicians in the development and customization of these tools to ensure they align with clinical workflows and are user-friendly. Additionally, offering incentives or rewards for utilizing these tools effectively can motivate healthcare providers to incorporate them into their practice. Continuous monitoring of the impact of these tools on patient outcomes and quality of care can also help in demonstrating their value, thereby encouraging broader adoption within healthcare systems.

What are the potential drawbacks or limitations of relying heavily on automated tools for medical screenings?

While automated tools like BPAs can significantly improve efficiency and accuracy in medical screenings, there are potential drawbacks and limitations to consider. One major concern is the risk of over-reliance on these tools, leading to complacency or reduced critical thinking among healthcare providers. Automated tools may also have limitations in handling complex or nuanced patient cases that require a more personalized approach. There is also the issue of data accuracy and reliability, as these tools rely on the quality of input data in electronic health records (EHRs). Privacy and security concerns related to the storage and sharing of patient data through automated tools are also important considerations that need to be addressed.

How can the integration of artificial intelligence further enhance the effectiveness of BPAs in healthcare beyond PA screening?

The integration of artificial intelligence (AI) can further enhance the effectiveness of Best Practice Advisories (BPAs) in healthcare by enabling more sophisticated decision-making algorithms and predictive analytics. AI can analyze vast amounts of patient data from electronic health records (EHRs) to identify patterns, trends, and risk factors that may not be readily apparent to healthcare providers. By leveraging AI, BPAs can offer more personalized and targeted recommendations for patient care, leading to improved outcomes and efficiency. AI can also help in automating routine tasks, freeing up healthcare providers to focus on more complex aspects of patient care. Additionally, AI can continuously learn and adapt based on new data inputs, making BPAs more dynamic and responsive to evolving healthcare needs.