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Peer-reviewedCC BY 4.0JACC Case Reports

Enhancing Cardiac Rehabilitation Referral at Discharge Using EHR-Based Decision Support for Guideline-Eligible Patients

  • Mohanad Albayyaa1
  • Shiva Gollapally Krishna1
  • Qamar Othman Abdullah2
  • Ibrahim Mortada1
  • Riham Dheyab3
  • Abdul Qadeer1
  • Carolina Colli Cruz1
  • Jesús Gibran Hernández-Pérez4
  • Omer Abdelgadir4
  • David S. Lopez4
  • Hani Jneid1
  • Bashar Al hemyari1
4 affiliations
  1. 1Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, Texas, USA
  2. 2Department of Clinical Pharmacy, College of Pharmacy, Ashur University, Baghdad, Iraq
  3. 3Department of Pharmacy, Kelsey Seybold Clinic, Pearland, Texas, USA
  4. 4Peter O’Donnell School of Public Health, UT Southwestern Medical Center, Dallas, Texas, USA
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Abstract

Background: Cardiac rehabilitation (CR) is a guideline-recommended therapy that improves outcomes in cardiovascular disease, yet referral at hospital discharge remains suboptimal.

Project Rationale: Variability in discharge workflows and inconsistent use of standardized referrals contributed to missed CR referrals among eligible patients.

Project Summary: We implemented an electronic health record (EHR)–based best practice advisory within the Epic EHR system to prompt CR referral or documentation of nonreferral reasons for guideline-eligible cardiovascular patients. A retrospective quality improvement study compared preimplementation (February 1, 2022–January 31, 2024) and postimplementation (February 1, 2024–January 31, 2026) cohorts (N = 21,294). Outcomes assessed included CR referral orders, documentation of referral activity, and CR-related activity. CR referral rates increased from 45.3% to 86.7% after best practice advisory implementation.

Take-Home Messages: EHR-based decision support improved CR referral rates among guideline-eligible patients by integrating referral prompts into discharge workflows. Continued optimization of provider engagement and workflow integration may further improve referral completion.

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Cite

BibTeXRIS
BibTeX
@article{albayyaa2026enhancing,
  title = {{Enhancing Cardiac Rehabilitation Referral at Discharge Using EHR-Based Decision Support for Guideline-Eligible Patients}},
  author = {Mohanad Albayyaa and Shiva Gollapally Krishna and Qamar Othman Abdullah and Ibrahim Mortada and Riham Dheyab and Abdul Qadeer and Carolina Colli Cruz and Jesús Gibran Hernández-Pérez and Omer Abdelgadir and David S. Lopez and Hani Jneid and Bashar Al hemyari},
  journal = {JACC Case Reports},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jaccas.2026.110346},
  url = {https://doi.org/10.1016/j.jaccas.2026.110346},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Enhancing Cardiac Rehabilitation Referral at Discharge Using EHR-Based Decision Support for Guideline-Eligible Patients
AU  - Mohanad Albayyaa
AU  - Shiva Gollapally Krishna
AU  - Qamar Othman Abdullah
AU  - Ibrahim Mortada
AU  - Riham Dheyab
AU  - Abdul Qadeer
AU  - Carolina Colli Cruz
AU  - Jesús Gibran Hernández-Pérez
AU  - Omer Abdelgadir
AU  - David S. Lopez
AU  - Hani Jneid
AU  - Bashar Al hemyari
PY  - 2026
DA  - 2026/09/16
JO  - JACC Case Reports
DO  - 10.1016/j.jaccas.2026.110346
UR  - https://doi.org/10.1016/j.jaccas.2026.110346
AB  - Background: Cardiac rehabilitation (CR) is a guideline-recommended therapy that improves outcomes in cardiovascular disease, yet referral at hospital discharge remains suboptimal.  Project Rationale: Variability in discharge workflows and inconsistent use of standardized referrals contributed to missed CR referrals among eligible patients.  Project Summary: We implemented an electronic health record (EHR)–based best practice advisory within the Epic EHR system to prompt CR referral or documentation of nonreferral reasons for guideline-eligible cardiovascular patients. A retrospective quality improvement study compared preimplementation (February 1, 2022–January 31, 2024) and postimplementation (February 1, 2024–January 31, 2026) cohorts (N = 21,294). Outcomes assessed included CR referral orders, documentation of referral activity, and CR-related activity. CR referral rates increased from 45.3% to 86.7% after best practice advisory implementation.  Take-Home Messages: EHR-based decision support improved CR referral rates among guideline-eligible patients by integrating referral prompts into discharge workflows. Continued optimization of provider engagement and workflow integration may further improve referral completion.
SN  - 2666-0849
ER  -