Document Type

Article

Publication Date

9-16-2026

Comments

This article is the author’s final published version in JACC: Case Reports, Volume 31, Issue 37, 2026, Article number 109816.

The published version is available at https://doi.org/10.1016/j.jaccas.2026.109816. Copyright © 2026 The Authors.

 

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.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

42752023

Language

English

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