Best practice advisory piloted for patients with atrial fibrillation

In an effort to reduce variability in anticoagulation management for patients with atrial fibrillation (AF), the Integrated Care Model (ICM) initiative was launched last May. The multidisciplinary team, which has met weekly since the launch, has designed a best practice advisory (BPA) for eligible patients with AF who are not currently anticoagulated. The ultimate goal in increasing oral anticoagulation use for appropriate patients is to decrease thromboembolism and stroke.

The BPA was activated on Nov. 29, 2019 for a limited number of pilot clinicians practicing in primary care and cardiology. It applies to patients with a history of AF who are not on anticoagulation treatment and have an auto-calculated CHA2DS2-VASc risk score of ≥ 2 for men or ≥ 3 for women. A newly created smart set will give clinicians the option to initiate anticoagulation, refer to cardiology, document a contraindication, refer to interventional cardiology for evaluation for left atrial appendage occlusion (LAAO) or refer to a pharmacist (in select locations). The BPA is slowly being activated for additional clinicians based on pilot clinician feedback.

The BPA will alert the clinician, electronically, once per year, so that the need for anticoagulation can be addressed, improving care safety, quality and efficiency for patients with AF.