Abstract 20: Cardiovascular Health Trends in Electronic Health Record Data (2010-2015): the Guideline Advantage
Background: Electronic health records (EHRs) are an increasingly valuable data source for monitoring population health. However, EHR data are rarely shared across health system borders, limiting their utility to researchers and policymakers. The Guideline Advantage™ (TGA) program, a joint initiative by the American Heart Association (AHA), American Cancer Society, and American Diabetes Association, brings together data from EHRs across the country to support disease prevention and management efforts in the outpatient setting.
Methods: We analyzed TGA EHR data from >70 clinics comprising 281,837 adult patients from 2010 to 2015. We used the first available measure per patient for each calendar year to characterize trends in the proportion of patients in “ideal”, “intermediate”, and “poor” CVH categories for blood pressure (BP), body mass index (BMI) and smoking. Total cholesterol and fasting glucose values were not reported to TGA. Thus, we used low-density lipoprotein (LDL) and hemoglobin A1c (A1c) treatment guidelines to classify patients into CVH categories for the respective metrics.
Results: Patients were an average of 50 years old, and 57.4% were female. Of records with complete data on race, 70.9% of patients were white. Over 6 years of observation, we documented increases in the proportion of patients at ideal levels for BP, smoking, LDL, and A1c, but decreases in the proportion of patients at an ideal level for BMI (Figure).
Conclusions: TGA data provide a large-scale perspective of outpatient CVH, yet we acknowledge limitations associated with using EHR data to assess trends in CVH. Specifically, EHR data entry is clinically-driven - BP and BMI values are likely to be updated at each visit for each patient, while smoking status, LDL, and A1c are not. Our analysis lays the groundwork for EHR analyses as these data become less siloed and more accessible to stakeholders.
Figure. Trends in CVH from 2010 to 2015: The Guideline Advantage™
Author Disclosures: R. Foraker: None. S. Patel: None. Y. Khan: None. M. Bauman: None. J. Bower: None.
- © 2017 by American Heart Association, Inc.