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Peer-reviewedCC BY-NC-ND 4.0JACC Case Reports

Hammering Heart Failure

  • Sheraz Qamar1
  • Andres Alvarado2
  • Thomas Buckwalter2
  • Patricia Henwood2
  • Cara Martino2
  • Matthew Metzinger2
  • Heather Morgan2
  • Jeffrey Riggio1
  • Jared Vanderzell2
  • Alan Kubey1,3
  1. 1Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
  2. 2Jefferson Health, Philadelphia, Pennsylvania, USA
  3. 3Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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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.

Project 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.

Project 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).

Take-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.

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Cite

BibTeXRIS
BibTeX
@article{qamar2026hammering,
  title = {{Hammering Heart Failure}},
  author = {Sheraz Qamar and Andres Alvarado and Thomas Buckwalter and Patricia Henwood and Cara Martino and Matthew Metzinger and Heather Morgan and Jeffrey Riggio and Jared Vanderzell and Alan Kubey},
  journal = {JACC Case Reports},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jaccas.2026.109814},
  url = {https://doi.org/10.1016/j.jaccas.2026.109814},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Hammering Heart Failure
AU  - Sheraz Qamar
AU  - Andres Alvarado
AU  - Thomas Buckwalter
AU  - Patricia Henwood
AU  - Cara Martino
AU  - Matthew Metzinger
AU  - Heather Morgan
AU  - Jeffrey Riggio
AU  - Jared Vanderzell
AU  - Alan Kubey
PY  - 2026
DA  - 2026/09/16
JO  - JACC Case Reports
DO  - 10.1016/j.jaccas.2026.109814
UR  - https://doi.org/10.1016/j.jaccas.2026.109814
AB  - Background: Heart failure (HF) remains a leading cause of hospitalization, mortality, and readmission. Despite evidence-based therapies, achieving consistent system-wide implementation remains challenging.  Project 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.  Project 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).  Take-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.
SN  - 2666-0849
ER  -