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

EHR-Based Quality Interventions Associated With Differential GDMT Prescribing in Community Versus Academic Hospitals

  • Trisha Sindhu1
  • Charlotte Pirquet1
  • Sheraz Qamar1
  • Tanay-Veer Gandhi1
  • Patricia Henwood2
  • Cara Martino2
  • Jeffrey Riggio1
  • Jared Vanderzell2
  • Charlotte Sacksteder2
  • 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: Institutional barriers are associated with suboptimal guideline-directed medical therapy (GDMT) prescribing at heart failure discharge.

Project Rationale: Practice variations between academic medical centers (defined as “teaching” hospitals with residents) and community hospitals are poorly understood. Evaluating how diverse settings respond to quality improvement strategies is vital.

Project Summary: A multicenter study across 10 electronic health record–unified hospitals evaluated 3,535 heart failure encounters. Phase 1 implemented educational work groups and financial incentives; phase 2 introduced clinical decision support systems. Community hospitals responded significantly to phase 1 education/incentives, with mean discharge of GDMT agents rising from 2.19 to 2.44 (P = 0.0028). Academic medical centers improved significantly only after the implementation of phase 2 clinical decision support systems, rising from 2.27 to 2.48 GDMT agents (P = 0.0009).

Take-Home Messages: Community settings respond to education and financial incentives, whereas academic settings require hardwired digital workflows. Enterprise quality improvement initiatives must match deployment strategies to institutional context.

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Cite

BibTeXRIS
BibTeX
@article{sindhu2026ehrbased,
  title = {{EHR-Based Quality Interventions Associated With Differential GDMT Prescribing in Community Versus Academic Hospitals}},
  author = {Trisha Sindhu and Charlotte Pirquet and Sheraz Qamar and Tanay-Veer Gandhi and Patricia Henwood and Cara Martino and Jeffrey Riggio and Jared Vanderzell and Charlotte Sacksteder and Alan Kubey},
  journal = {JACC Case Reports},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jaccas.2026.109888},
  url = {https://doi.org/10.1016/j.jaccas.2026.109888},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - EHR-Based Quality Interventions Associated With Differential GDMT Prescribing in Community Versus Academic Hospitals
AU  - Trisha Sindhu
AU  - Charlotte Pirquet
AU  - Sheraz Qamar
AU  - Tanay-Veer Gandhi
AU  - Patricia Henwood
AU  - Cara Martino
AU  - Jeffrey Riggio
AU  - Jared Vanderzell
AU  - Charlotte Sacksteder
AU  - Alan Kubey
PY  - 2026
DA  - 2026/09/16
JO  - JACC Case Reports
DO  - 10.1016/j.jaccas.2026.109888
UR  - https://doi.org/10.1016/j.jaccas.2026.109888
AB  - Background: Institutional barriers are associated with suboptimal guideline-directed medical therapy (GDMT) prescribing at heart failure discharge.  Project Rationale: Practice variations between academic medical centers (defined as “teaching” hospitals with residents) and community hospitals are poorly understood. Evaluating how diverse settings respond to quality improvement strategies is vital.  Project Summary: A multicenter study across 10 electronic health record–unified hospitals evaluated 3,535 heart failure encounters. Phase 1 implemented educational work groups and financial incentives; phase 2 introduced clinical decision support systems. Community hospitals responded significantly to phase 1 education/incentives, with mean discharge of GDMT agents rising from 2.19 to 2.44 (P = 0.0028). Academic medical centers improved significantly only after the implementation of phase 2 clinical decision support systems, rising from 2.27 to 2.48 GDMT agents (P = 0.0009).  Take-Home Messages: Community settings respond to education and financial incentives, whereas academic settings require hardwired digital workflows. Enterprise quality improvement initiatives must match deployment strategies to institutional context.
SN  - 2666-0849
ER  -