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EHR-Based Screening Program for Abdominal Aortic Aneurysms Cuts the Number of Unscreened At-Risk Men by More than Half

February 10, 2014



Older male physician pointing to computer screen while talking to older male patient in doctor's office

PASADENA, Calif.A screening program for abdominal aortic aneurysms, integrated into an electronic health record, dramatically reduced the number of unscreened at-risk men by more than 50 percent within 15 months, according to a Kaiser Permanente study published today in the Journal of Vascular Surgery. An abdominal aortic aneurysm is a balloon-like bulge in the aorta, which — if ruptured — can result in death. It is estimated that more than one million Americans are living with undiagnosed AAA, according to the Society for Vascular Surgery.

Since 2005, the U.S. Preventive Services Task Force and the American Heart Association have recommended screening in men aged 65 to 75 years with any history of smoking. Researchers examined the EHRs of 68,164 men who met these initial screening criteria. The researchers created an alert in the EHR to signal providers that the patient should be screened for AAA, and then followed these men from March 2012 to June 2013. The alerts led to a system-wide reduction of unscreened patients from 51.74 percent to 20.26 percent.

“Because abdominal aortic aneurysms are generally asymptomatic before they burst, most of the patients who have a rupture didn’t even know that they had an aneurysm,” said Robert J. Hye, MD, study lead author and chief of vascular surgery, Kaiser Permanente San Diego Medical Center. “That makes screening for AAA all the more vital and important.”

More than 50 percent of ruptured AAAs result in death, according to the American Heart Association. Approximately 10,000 Americans die as a result of a ruptured of AAA each year, according to the Centers for Disease Control and Prevention.

“Because of the distinctive nature of Kaiser Permanente’s health care system with its integrated network of practitioners and physicians, it is uniquely suited to perform these types of preventive health measures like aneurysm screening, colon cancer screening, and others,” said Dr. Hye. “This type of program would be very hard to implement in a non-integrated system because their practitioners don’t have universal EHRs to help them monitor their patients.”

Kaiser Permanente has published numerous studies about the benefits of Kaiser Permanente HealthConnect®, the EHR it launched in 2004. A study published in the Journal of the American Medical Informatics Association in October 2013 found that using EHRs to automate reporting of quality measures reduces reporting time required for one measure set alone by about 50 percent. Another study also published that month in the Journal of the American Medical Association found that the use of EHRs in clinical settings was associated with a decrease in emergency room visits and hospitalizations for patients with diabetes.

Securely connecting 9.1 million people, 618 medical offices and 38 hospitals, KP HealthConnect is the largest and most advanced non-governmental electronic health record in the world. KP HealthConnect links patients with their health care teams, their personal health information and the latest medical knowledge. It also connects Kaiser Permanente’s researchers to one of the most extensive collections of longitudinal medical data available, facilitating studies and important medical discoveries that shape the future of health and care delivery for patients and the medical community.

Other authors on the study include Andrea E. Smith, MSN, RN, PHN, Regional Outpatient Safety Net, Kaiser Permanente Southern California, Pasadena, Calif.; Gary H. Wong, MD, MPH, Department of Population Care Management, Kaiser Permanente Southern California, Fontana, Calif.; Southida S. Vansomphone, PharmD, Department of Pharmacy Analytical Services, Kaiser Permanente Southern California, Downey, Calif.; Ronald D. Scott, MD, Department of Lipidology and Family Medicine, Kaiser Permanente Southern California, West Los Angeles; and Michael H. Kanter, MD, Department of Quality and Clinical Analysis, Administration, Kaiser Permanente Southern California, Pasadena.

About the Kaiser Permanente Department of Research & Evaluation
The Department of Research & Evaluation conducts high-quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiology, health sciences and behavioral research as well as clinical trials. Areas of interest include diabetes and obesity, cancer, HIV/AIDS, cardiovascular disease, aging and cognition, pregnancy outcomes, women’s and children’s health, quality and safety, and pharmacoepidemiology. Located in Pasadena, Calif., the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general population. Visit kp.org/research.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 9.1 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to kp.org/share.