A Health Equity Workflow for Timely Transcatheter Aortic Valve Replacement
- 1Lake Charles Memorial Health System, Heart & Vascular Center, Lake Charles, Louisiana, USA
Abstract
Background: Severe aortic stenosis is associated with morbidity and mortality when untreated, making timely valve intervention essential. Transportation, financial, dental, caregiver, and care coordination barriers may delay progression through transcatheter aortic valve replacement (TAVR) evaluation.
Project Rationale: Lake Charles Memorial Hospital identified missed appointments, variable referral progression, and inconsistent recognition of social determinants of health (SDOH) barriers during TAVR evaluation.
Project Summary: Beginning in 2023, transportation, dental, financial, and community resource pathways were expanded. A structural heart-specific Epic workflow later incorporated referral intake screening, SDOH screening, dental SmartPhrases, electronic resource connection, referral escalation, and dashboard monitoring. Across the cumulative phased workflow redesign, missed or rescheduled visits decreased from 31% to 3%, and referral-to-treatment interval improved from 43 to 20 days. During the pilot from 2025 Q4 to 2026 Q1, Epic SDOH screening completion reached 100%.
Take-Home Message: Referral intake and SDOH screening can identify barriers and connect patients to resources supporting timely valve intervention.
Related
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BibTeX
@article{theriot2026health,
title = {{A Health Equity Workflow for Timely Transcatheter Aortic Valve Replacement}},
author = {Misty L. Theriot and J. Gregory Lugo},
journal = {JACC Case Reports},
year = {2026},
month = sep,
doi = {10.1016/j.jaccas.2026.109536},
url = {https://doi.org/10.1016/j.jaccas.2026.109536},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - A Health Equity Workflow for Timely Transcatheter Aortic Valve Replacement
AU - Misty L. Theriot
AU - J. Gregory Lugo
PY - 2026
DA - 2026/09/16
JO - JACC Case Reports
DO - 10.1016/j.jaccas.2026.109536
UR - https://doi.org/10.1016/j.jaccas.2026.109536
AB - Background: Severe aortic stenosis is associated with morbidity and mortality when untreated, making timely valve intervention essential. Transportation, financial, dental, caregiver, and care coordination barriers may delay progression through transcatheter aortic valve replacement (TAVR) evaluation. Project Rationale: Lake Charles Memorial Hospital identified missed appointments, variable referral progression, and inconsistent recognition of social determinants of health (SDOH) barriers during TAVR evaluation. Project Summary: Beginning in 2023, transportation, dental, financial, and community resource pathways were expanded. A structural heart-specific Epic workflow later incorporated referral intake screening, SDOH screening, dental SmartPhrases, electronic resource connection, referral escalation, and dashboard monitoring. Across the cumulative phased workflow redesign, missed or rescheduled visits decreased from 31% to 3%, and referral-to-treatment interval improved from 43 to 20 days. During the pilot from 2025 Q4 to 2026 Q1, Epic SDOH screening completion reached 100%. Take-Home Message: Referral intake and SDOH screening can identify barriers and connect patients to resources supporting timely valve intervention.
SN - 2666-0849
ER -