Optimizing Stroke Prophylaxis of Acute Atrial Fibrillation With an Electronic Clinical Decision Support Tool (AF SWCRT-CDS)
Atrial Fibrillation
About this trial
This is an interventional other trial for Atrial Fibrillation
Eligibility Criteria
Inclusion Criteria (Patients):
- A diagnosis of atrial fibrillation or paroxysmal atrial fibrillation (ICD-10 I48.0, I48.1, I48.9) during an ED visit with start dates between 1/11/2022 and 12/31/2025 within the patient's age >18 years.
Exclusion Criteria (Patients):
- Valvular disease, pregnancy, large esophageal varices, thrombocytopenia, severe or uncontrolled bleeding, severe liver or kidney disease, major surgery within 72 hours; OR
- Recent brain, eye or spinal cord injury or surgery; OR
- ED stroke, death or hospitalization at index visit; OR
- Patient transferred from another hospital (to ensure availability of index ED visit data); OR
- Left against medical advice; OR
Evidence of non-OAC naïve patient:
- OAC prescribed in the prior 3mo to index ED visit; OR
- Being managed by an anticoagulation clinic (ACC);
Inclusion/Exclusion Criteria (Clinicians): All ED clinicians (board certified or eligible) interfacing with patients.
Sites / Locations
- Oregon Health & Science University (OHSU)
Arms of the Study
Arm 1
Arm 2
Arm 3
Other
Other
Other
Link-Out
BPA + Link-out
BPA + FHIR
Clinicians will be trained on the web-based portal of the CDS tool and shown where the Link to the tool will be available in the EHR.
Clinicians will be trained on how a BPA is triggered when a patient is diagnosed with AF. The alert will pop up within the EHR with the Link-out to the web portal.
Instead of a link to the web-based portal, the BPA will contain a link to the FHIR-integrated CDS tool portal. FHIR will automatically pull EHR data about the patient into the CDS tool portal. Data include demographic information, comorbidities in the active problem list, past medical and surgical history, and social history. Clinicians will also receive training before the implementation of this step.