Computer-Assisted Protocol-Adherent Blood Lipid Evaluation in Vascular Outpatients (CAPABLE-Vascular)

TL;DR

A computer-assisted system was tested to ensure vascular outpatients get necessary blood tests, showing significant improvement in test ordering rates.

Contribution

A rule-based system was developed and implemented to improve protocol-adherent test ordering in vascular outpatient clinics.

Findings

100% of patients had HbA1c and lipid studies ordered post-intervention, compared to 38.0% and 17.9% pre-intervention.

The intervention showed a statistically significant improvement in test ordering rates (p < 0.001).

Abstract

Background: The lack of availability of test results in vascular surgery outpatient clinics impedes the medical management of vascular risk factors, such as dyslipidaemia and diabetes mellitus. This study sought to evaluate the feasibility of using computer-assisted processes to promote the ordering of routine investigations to promote this management. Method: After consultation with specialist clinicians, clinician–programmers developed a rule-based system to facilitate the ordering of lipid studies and HbA1c prior to vascular clinic appointments. A four-week historical control period prior to the initiation of the intervention was compared to a four-week period following the intervention. Results: There were 1165 patients in the study. In the pre-intervention period, 38.0% of patients had HbA1c and 17.9% had lipid studies in the preceding 6 months. In the post-intervention period, HbA1c and lipid studies were ordered for 100% of vascular outpatients (p < 0.001). Conclusions: The use of computer-assisted processes to facilitate the requesting of routine outpatient investigations is feasible and shows early signs of being effective. Follow-up studies examining clinical endpoints are required.

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