A pilot program using several clinical decision-support tools in the outpatient setting to treat and educate stable ischemic heart disease (SIHD) patients has shown success in improving angina, according to findings from the Florida Cardiovascular Quality Network study presented Feb. 14 at ACC's Cardiovascular Summit in Orlando, FL.

Using data from the Florida Cardiovascular Quality Network, researchers analyzed 254 patients who all had angina symptoms and presented for clinical evaluation. There were 188 patients in group A (without preexisting SIHD), and 66 patients in group B (with preexisting SIHD). The overall patient population was 53 percent female and 47 percent male and had an average age of 64 years. Three apps were used in the study: ACC FOCUS as a clinical decision-support app for imaging appropriate use criteria documentation, the Seattle Angina Questionnaire app to determine symptom severity and quality of life, and ACC's CardioSmart Heart Explorer App to educate patients.

The apps were provided to the care teams in tablet format, and each patient's data was securely entered. The data output from each app was available and shared as routine clinical information available on each patient. This protocol was repeated at each patient visit: baseline, 3 months, 6 months and 12 months. The specific apps chosen were consistent with the underlying SIHD diagnosis. Results found the apps successfully helped ensure appropriate use of imaging; measure angina frequency, severity and quality of life; and educate patients about the importance of mitigating risk.

"Clinical decision-support tools [apps] help effectively translate guidelines into a format that assists the provider with the integration of guideline-based diagnostic and treatment recommendations into clinical practice," said A. Allen Seals, MD, FACC, lead study author. "Importantly, the utilization of multiple apps proved to be clinically feasible and did not overly impair efficiency of the team-based providers. In a team-based environment, patients should welcome the utilization of apps at the point of care and have confidence that these apps will have excellent value to their provider to improve the quality of cardiovascular care."

Looking to the future, the researchers note several key questions that need to be answered, including whether structured use of apps at the point of care can be proven to impact quality of care in a larger patient population as well as in other disease states such as high cholesterol or atrial fibrillation. Also, it remains to be demonstrated that a systematic use of clinical decision-support apps will positively impact long term outcomes such as decreasing hospitalizations and lowering mortality.

Keywords: CV Summit, Atrial Fibrillation, Decision Support Systems, Clinical, Outpatients, Point-of-Care Systems, Pilot Projects, Quality of Life, Angina Pectoris, Coronary Artery Disease, Myocardial Ischemia, Hypercholesterolemia, Hospitalization, Cholesterol

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