Evaluating Electronic Health Record Intervention Efficacy in Enhancing Inpatient Initiation of Guideline-Directed Medical Therapy
- 1Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
- 2Jefferson Health, Philadelphia, Pennsylvania, USA
- 3Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
Abstract
Background: Heart failure (HF) is a leading cause of hospitalization, morbidity, and mortality. Despite evidence supporting guideline-directed medical therapy (GDMT), prescribing remains suboptimal, particularly at hospital discharge.
Project Rationale: Hospitalization provides an opportunity to initiate or optimize GDMT, but workflow barriers and practice variation limit implementation. To address this gap, our system implemented a system-wide HF quality improvement initiative featuring evidence-based order sets and an electronic health record smart phrase (“HFNOTE”) to centralize and standardize documentation and encourage GDMT use.
Project Summary: We analyzed 2,859 HF hospitalizations across 10 hospitals between December 1, 2024 and June 30, 2025. Use of HFNOTE and admission order sets was significantly associated with higher rates of 4-pillar GDMT prescribing in heart failure with reduced ejection fraction/heart failure with improved ejection fraction and sodium-glucose cotransporter-2 inhibitor prescribing in heart failure with preserved ejection fraction/heart failure with mildly reduced ejection fraction, with relative improvements ranging from 31% to 58%.
Take-Home Messages: Scalable electronic health record–based tools, including standardized order sets and documentation, may meaningfully improve adherence to evidence-based HF therapy.
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BibTeX
@article{qamar2026evaluating,
title = {{Evaluating Electronic Health Record Intervention Efficacy in Enhancing Inpatient Initiation of Guideline-Directed Medical Therapy}},
author = {Sheraz Qamar and Trisha Sindhu and Charlotte Pirquet and Benjamin Richter and Charlotte Sacksteder and Tatianna Branch and Jeffrey Riggio and Cara Martino and Patricia Henwood and Alan Kubey},
journal = {JACC Case Reports},
year = {2026},
month = sep,
doi = {10.1016/j.jaccas.2026.109815},
url = {https://doi.org/10.1016/j.jaccas.2026.109815},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Evaluating Electronic Health Record Intervention Efficacy in Enhancing Inpatient Initiation of Guideline-Directed Medical Therapy
AU - Sheraz Qamar
AU - Trisha Sindhu
AU - Charlotte Pirquet
AU - Benjamin Richter
AU - Charlotte Sacksteder
AU - Tatianna Branch
AU - Jeffrey Riggio
AU - Cara Martino
AU - Patricia Henwood
AU - Alan Kubey
PY - 2026
DA - 2026/09/16
JO - JACC Case Reports
DO - 10.1016/j.jaccas.2026.109815
UR - https://doi.org/10.1016/j.jaccas.2026.109815
AB - Background: Heart failure (HF) is a leading cause of hospitalization, morbidity, and mortality. Despite evidence supporting guideline-directed medical therapy (GDMT), prescribing remains suboptimal, particularly at hospital discharge. Project Rationale: Hospitalization provides an opportunity to initiate or optimize GDMT, but workflow barriers and practice variation limit implementation. To address this gap, our system implemented a system-wide HF quality improvement initiative featuring evidence-based order sets and an electronic health record smart phrase (“HFNOTE”) to centralize and standardize documentation and encourage GDMT use. Project Summary: We analyzed 2,859 HF hospitalizations across 10 hospitals between December 1, 2024 and June 30, 2025. Use of HFNOTE and admission order sets was significantly associated with higher rates of 4-pillar GDMT prescribing in heart failure with reduced ejection fraction/heart failure with improved ejection fraction and sodium-glucose cotransporter-2 inhibitor prescribing in heart failure with preserved ejection fraction/heart failure with mildly reduced ejection fraction, with relative improvements ranging from 31% to 58%. Take-Home Messages: Scalable electronic health record–based tools, including standardized order sets and documentation, may meaningfully improve adherence to evidence-based HF therapy.
SN - 2666-0849
ER -