The first step was to develop the electronic system. The authors say, “The alert system automatically identified hospitalized patients with AF without an active OAC prescription in the electronic order entry system,” adding that the alert was incorporated into the existing computer system of the University Hospital in Bern, Switzerland.
The results of this study, along with one previously conducted regarding electronic alerts to prevent venous thromboembolism, “there is increasing evidence supporting the implementation of computerized decision support systems in cardiovascular medicine,” according to the researchers.
Patients with AF are at a greater risk of stroke, but treatment with OAC with vitamin K reduces that risk by approximately 80%. However, undertreatment and adherence to treatment are problems. In the present study, researchers investigated whether using an electronic alert system to make physicians aware of the problem would improve the rate at which OAC therapy was prescribed.
One limitation of the alert system “was the high rate of non-sense alerts for patients who were not OAC-naive because alerts were often not issued before anticoagulation treatment was ordered through the electronic prescription system,” say the authors. However, the problem was solved by changing the system to send alerts 24 hours after hospital admission rather than immediately upon admission.