Mobilizing a Million Hearts: Outstanding Research at the Symposium
At the 2019 MedStar Health-Georgetown University Research Symposium, three abstracts were recognized as outstanding abstracts from among all of our submissions. These research studies were the three highest scored out of the over 450 submissions to the Research Symposium by the Scientific Review committee and exemplifies the caliber of work presented by the MedStar-Georgetown research community.
The purpose of “Mobilizing a Million Hearts: Process Mapping of Cardiac Risk Assessment and Discussion” is an effort to optimize current cardiac risk calculators that are being used to predict patient 10-year risk. The work sought to identify individuals at high risk for atherosclerotic cardiovascular disease (ASCVD) who would benefit the most from cardiac risk management.
The research team was led by Ronald Romero Barrientos, with funding through the Office of the National Coordinator for Health Information Technology. This research was presented in the health services research category at the MedStar-Georgetown Research Symposium.
The research team analyzed physician workflow to better understand the current state and needs of physicians when using cardiac risk calculators. The overall goal is to optimize an ASCVD risk tool that implements a comprehensive method of communicating cardiovascular risk that is fully integrated into clinician workflow.
The study included a total of 17 clinician interviews that were conducted among cardiologists (n=6), primary care physicians (n=7), and care navigators (n=4). Also, 30 hours of clinical observations were conducted. During data analysis, common trends across 34 visits were identified and developed a general process outline for the sequence of events during patient visits. Six out of the total 34 visits were process mapped to confirm this general trend and highlight individual differences. These process maps illustrated that ASCVD risk discussion manifested itself during these patient visits as either a physician-initiated probe into patient lifestyle, physician education of risk factor management, or physician and patient discussion revolving around medication management.
The research collaborators were Lucy Stein, Laura Schubel, Mark Townsend, Kevin Chaney, and Kristen Miller. These researchers from MedStar Health Research Institute, MedStar National Center for Human Factors in Healthcare, MedStar National Rehabilitation Hospital, and the MedStar Institute for Innovation found that the results of the research revealed implications for both technical design and optimization of the risk calculator. Application of this workflow analysis process will be used in future endeavours to optimize and integrate clinical decision support tools directly into clinician workflow.