EHR Alert System for Hemorrhagic Stroke

Overseen By Ernst Mayerhofer, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Disqualifiers: Subdural, epidural hematoma, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

340 Participants Needed

Trial Summary

What is the purpose of this trial?

The overall goal of this study is to increase health care provider awareness for common risk factors and comorbidities in patients with hemorrhagic stroke that are related to impaired brain health, to ultimately improve patients management and associated outcomes. The specific objective is to test the performance and effectiveness of a custom electronic health record (EHR)-based notification module at time of index hospitalization and at follow-up for hemorrhagic stroke survivors, before disparities in access to outpatient care may limit opportunities to intervene. The investigators hypothesize that notification of health care providers through the EHR will increase measurements of low-density lipoprotein (LDL) and glycated hemoglogbin A1c (HbA1c) and increase evaluation and management rates for obstructive sleep apnea and hearing impairment.

Research Team

Christopher D Anderson, MD MMSc

Principal Investigator

Brigham and Women's Hospital

Eligibility Criteria

This trial is for adults over 18 who have had a hemorrhagic stroke and are admitted to the Massachusetts General Hospital inpatient stroke service. It's not open to those with subdural or epidural hematoma, or anyone who doesn't fit the main inclusion criteria.

Inclusion Criteria

I am 18 or older and was admitted to Massachusetts General Hospital for a hemorrhagic stroke.

Exclusion Criteria

Patients not meeting above inclusion criteria

I have a blood clot between my skull and brain or in the outer covering of my brain.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Index Hospitalization

Implementation of EHR-based notification module to increase awareness of risk factors and comorbidities during acute hemorrhagic stroke hospitalization

During hospitalization

In-patient visit

Follow-up

EHR-based notifications for follow-up care, including referrals for sleep study and audiology, and management of LDL and HbA1c levels

6 months

Out-patient visits

Extended Follow-up

Monitoring of LDL and HbA1c measurements over a 12-month period surrounding the stroke event

12 months

Treatment Details

Interventions

• In-patient and out-patient electronic health record alert

Trial Overview The study aims to see if alerting healthcare providers through electronic health records about risk factors and comorbidities can improve management of patients after a hemorrhagic stroke. The focus is on increasing checks for cholesterol (LDL) levels, blood sugar control (HbA1c), sleep apnea, and hearing issues.

Participant Groups

Group I: Electronic Health Record Notification Experimental Treatment 1 Intervention

For eligible patients presenting with an acute hemorrhagic stroke, a recommendation to measure low-density lipoprotein (LDL) and glycated hemoglobin A1c (HbA1c) together with their last measurement dates will be displayed in the patient's electronic health record through a best practice alert (BPA). The alert will display for the patient's provider when they first open the patient's chart. The provider may accept the automatically generated orders for both measurements displayed in the BPA, may modify one or both of the orders, or choose to dismiss the BPA. For patients that follow-up with the out-patient stroke clinic and received the in-patient intervention, a second BPA will suggest referrals to sleep study and audiology. The alert will display for the patient's provider when they first open the patient's chart. The provider may accept one or both of the referrals suggested by the BPA, or may choose to dismiss the BPA.

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

Tufts University

Collaborator

Trials

271

Recruited

595,000+

Boston University

Collaborator

Trials

494

Recruited

9,998,000+