{
  "abstract": "Background: Heart failure (HF) remains a leading cause of hospitalization, mortality, and readmission. Despite evidence-based therapies, achieving consistent system-wide implementation remains challenging.\n\nProject Rationale: We evaluated the association of clinician education, incentive alignment, and electronic health record (EHR)–based clinical decision support systems (CDSS) with Vizient risk-adjusted mortality index and 30-day readmission index across a 20-hospital health system.\n\nProject Summary: Following a merger, hospitals served as natural control hospitals, received education/incentives alone (Cerner), or education/incentives plus EHR-CDSS (Epic). Education, incentives, and readmission case review were introduced on July 1, 2024, followed by HF-focused CDSS deployment in Epic on November 18, 2024. Compared with a seasonally matched controls, Epic hospitals demonstrated a 32% relative reduction in mortality index, whereas Cerner and control hospitals showed higher mortality ratios (1.55 and 1.23, respectively).\n\nTake-Home Messages: Education, incentives, and case review were associated with improved readmission performance, whereas EHR-based CDSS was associated with reductions in HF mortality, suggesting a scalable strategy to improve outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA",
    "Jefferson Health, Philadelphia, Pennsylvania, USA",
    "Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Sheraz Qamar"
    },
    {
      "affs": [
        1
      ],
      "name": "Andres Alvarado"
    },
    {
      "affs": [
        1
      ],
      "name": "Thomas Buckwalter"
    },
    {
      "affs": [
        1
      ],
      "name": "Patricia Henwood"
    },
    {
      "affs": [
        1
      ],
      "name": "Cara Martino"
    },
    {
      "affs": [
        1
      ],
      "name": "Matthew Metzinger"
    },
    {
      "affs": [
        1
      ],
      "name": "Heather Morgan"
    },
    {
      "affs": [
        0
      ],
      "name": "Jeffrey Riggio"
    },
    {
      "affs": [
        1
      ],
      "name": "Jared Vanderzell"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Alan Kubey"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/42jd89w8tp1hw.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jaccas.2026.109814",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13728359/",
  "id": "42jd89w8tp1hw",
  "issns": [
    "2666-0849"
  ],
  "landing_url": "https://doi.org/10.1016/j.jaccas.2026.109814",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Outcomes and Quality"
    ],
    [
      "heading",
      "Quality Improvement Projects"
    ],
    [
      "openalex",
      "2705|Heart Failure Treatment and Management"
    ]
  ],
  "openalex": "W7213437817",
  "pdf_url": null,
  "pmcid": "PMC13728359",
  "pmid": "42752025",
  "published": "2026-09-16",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/42jd89w8tp1hw.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:21:22Z",
      "native_id": "PMC13728359",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jaccas.2026.109814"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Heart Failure Treatment and Management",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Hammering Heart Failure",
  "title_text": "Hammering Heart Failure",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:21:22Z",
  "url": "https://research.draconitic.com/paper/42jd89w8tp1hw",
  "venue": "JACC Case Reports",
  "versions": []
}