Facilitated lipid management using interactive e-mail: preliminary results of a randomized controlled trial.
We describe the design and implementation of a clinical decision support system for ambulatory hyperlipidemia management. Despite readily available and evidence-based guidelines, cholesterol control remains persistently sub-optimal in clinical practice. "FastTrack" is an integrated, multi-faceted informatics tool to reduce barriers to effective cholesterol management by proactively integrating pertinent clinical information, evidence-based decision support and a simple means to act via a single FastTrack e-mail. We tested the intervention in a randomized, controlled trial involving 14 physicians and 276 patients. In an interim analysis, we found that physicians on average were able to review and act upon 9 patient e-mails in less than 15 minutes. Significantly more intervention patients were initiated on a statin therapy or had their dose increased (15.3% vs. 2.3%, p < 0.001). Impact of the intervention on LDL levels will be assessed at trial completion.
Lester
William T
WT
Laboratory of Computer Science, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114, USA.
Grant
Richard
R
Barnett
G Octo
GO
Chueh
Henry
H
D000368:Aged; D000553:Ambulatory Care; D008078:Cholesterol, LDL / Q000097:blood; D020000:Decision Support Systems, Clinical; D019468:Disease Management; D034742:Electronic Mail; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D016037:Single-Blind Method; D012984:Software
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors