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

Exploring Which EHR Interventions Improve Heart Failure Hospitalization Outcomes Across 10 Hospitals

  • Sheraz Qamar1
  • Andres Alvarado2
  • Thomas Buckwalter2
  • Patricia Henwood2
  • Dana Jordan2
  • Cara Martino2
  • Jeffrey Riggio1
  • Charlotte Sacksteder2
  • 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 major cause of mortality and hospitalization despite advances in guideline-directed medical therapy (GDMT). Electronic health record (EHR)-based clinical decision support tools may improve care delivery, but their impact on outcomes remains ill-defined.

Project Rationale: As part of a system-wide HF quality improvement initiative, we evaluated 2 EHR interventions: an evidence-based HF admission order set promoting early diuresis and GDMT optimization, and a templated HF documentation tool (HFNOTE) designed to capture clinical complexity.

Project Summary: We analyzed 4,865 HF hospitalizations across 10 hospitals between December 2024 and June 2025. Overall risk-adjusted mortality index was 0.83 and 30-day readmission index was 1.07. Both admission order set and HFNOTE use were associated with lower mortality index compared to nonuse. Readmission indices were similar across groups.

Take-Home Message: Targeted EHR interventions were associated with lower risk-adjusted inpatient mortality with a limited impact on 30-day readmissions, warranting further analyses to determine causal effects.

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Cite

BibTeXRIS
BibTeX
@article{qamar2026exploring,
  title = {{Exploring Which EHR Interventions Improve Heart Failure Hospitalization Outcomes Across 10 Hospitals}},
  author = {Sheraz Qamar and Andres Alvarado and Thomas Buckwalter and Patricia Henwood and Dana Jordan and Cara Martino and Jeffrey Riggio and Charlotte Sacksteder and Jared Vanderzell and Alan Kubey},
  journal = {JACC Case Reports},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jaccas.2026.109816},
  url = {https://doi.org/10.1016/j.jaccas.2026.109816},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Exploring Which EHR Interventions Improve Heart Failure Hospitalization Outcomes Across 10 Hospitals
AU  - Sheraz Qamar
AU  - Andres Alvarado
AU  - Thomas Buckwalter
AU  - Patricia Henwood
AU  - Dana Jordan
AU  - Cara Martino
AU  - Jeffrey Riggio
AU  - Charlotte Sacksteder
AU  - Jared Vanderzell
AU  - Alan Kubey
PY  - 2026
DA  - 2026/09/16
JO  - JACC Case Reports
DO  - 10.1016/j.jaccas.2026.109816
UR  - https://doi.org/10.1016/j.jaccas.2026.109816
AB  - Background: Heart failure (HF) remains a major cause of mortality and hospitalization despite advances in guideline-directed medical therapy (GDMT). Electronic health record (EHR)-based clinical decision support tools may improve care delivery, but their impact on outcomes remains ill-defined.  Project Rationale: As part of a system-wide HF quality improvement initiative, we evaluated 2 EHR interventions: an evidence-based HF admission order set promoting early diuresis and GDMT optimization, and a templated HF documentation tool (HFNOTE) designed to capture clinical complexity.  Project Summary: We analyzed 4,865 HF hospitalizations across 10 hospitals between December 2024 and June 2025. Overall risk-adjusted mortality index was 0.83 and 30-day readmission index was 1.07. Both admission order set and HFNOTE use were associated with lower mortality index compared to nonuse. Readmission indices were similar across groups.  Take-Home Message: Targeted EHR interventions were associated with lower risk-adjusted inpatient mortality with a limited impact on 30-day readmissions, warranting further analyses to determine causal effects.
SN  - 2666-0849
ER  -