Software Promotes NCEP/AHA Provider Guideline Adherence

DESCRIPTION (provided by applicant): Cardiovascular disease continues to be the leading cause of mortality and morbidity in the United States To assist health care practitioners in their integration of new information into clinical practice, professional organizations such as the National Cholesterol Education Program Expert Treatment Panel (ATP Ill), American Heart Association (AHA), American College of Cardiology (ACC), and Expert Treatment Panel (ATP III), Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI), develop guidelines to promote evidence-based standards of care in the management of cardiovascular disease. Despite the comprehensive nature and widespread dissemination of these guidelines, target parameters are not being achieved, and patients are not managed optimally. These diseases include achievement of lipid and blood pressure goals, usage of antiplatelet or anticoagulant therapy in patients with coronary artery disease and atrial fibrillation, usage of 13-blockers in patients post myocardial infarction, and the usage of t3-blockers and converting enzyme inhibitors in patients with systolic left ventricular dysfunction. The failure of implementation of optimal evidenced based guideline care has been attributed to a number of reasons including lack of knowledge of the guidelines and the failure of the guidelines to instruct the health care provider on strategies to implement the guidelines in individual patients. To facilitate the incorporation of these treatment guidelines in everyday medical practice, the Cardiac Goal Program software has been developed to prompt entry of data essential to the management of cardiovascular disease, based on Class I or Grade A recommendations using established guidelines, into standardized, computerized forms with a reminder system. The aims of the proposal are the incorporation of NCEP cholesterol treatment algorithms into the existing Cardiovascular Goal Program, employ usability methodologies, including in-depth interviews and focus groups with physicians, nurses, and physicians assistants, and refine the existing software based on the feedback from the practitioner's and retest the feasibility. If this automated clinical information and decision support system is successful and widely implemented, the best outcomes from care for chronic cardiovascular disease may be achieved.