AntiCoagulation Tracking InterVention and Evaluation (ACTIVE)

AntiCoagulation Tracking InterVention and Evaluation: Using a Customized Panel Management Platform to Improve Outcomes for Patients on Anticoagulation

Anticoagulants are a leading cause of acute injury from adverse drug events, leading to ~20,000 serious injuries reported to the Food and Drug Administration per year and more than 220,000 emergency department visits annually. Therefore, we propose to implement a health information technology (HIT) population management tool at two distinct anticoagulation clinics that will allow the care team to assign and track tasks essential for timely patient monitoring. We will examine its effect on anticoagulation management outcomes through a randomized trial, hypothesizing that such interventions can be effective as well as cost-effective strategies to improve patient safety in the context of anticoagulation management services.

Anticoagulation, Atrial Fibrillation, Atrial Flutter, Pulmonary Embolus/Emboli, Deep Vein Thrombosis, Stroke, Hypercoagulability

This cohort of patients will receive panel management through a customize software that integrates with the electronic health record

Patients in the intervention arm will receive notifications reminding them of upcoming labs and appointments. We hypothesize this will improve adherence and therapeutic control and reduce risk for bleeds and/or strokes

Using the Rosendaal method, we will assess the proportion of the treatment duration that the patient's International Normalized Ratio is within the goal therapeutic range.

Timeliness of treatment duration assessed as percentage of time on therapy in excess of what was prescribed

Inclusion Criteria: Adults (age ≥18 years) those prescribed an anticoagulation medication at Zuckerberg San Francisco General Hospital or University of California, San Francisco Health Exclusion Criteria: Minors (age<18) those not prescribed anticoagulation medication at ZSFG or UCSF Health