Impact of MayoExpertAdvisor on Provider Adherence (MEA Research)

April 16, 2019 updated by: Paul M. McKie, M.D., Mayo Clinic

Impact of MayoExpertAdvisor (MEA) on Provider Adherence to Guideline Recommended Treatment for Hyperlipidemia, Atrial Fibrillation, and Heart Failure

This study evaluates the efficacy of MayoExpertAdvisor (MEA), a knowledge delivery tool, to improve adherence to best practices for patients with hyperlipidemia, atrial fibrillation and heart failure. Half of the clinicians will receive MEA, while the other half will not receive MEA.

The investigators hypothesize care teams with access to MEA will act upon recommendations at a higher rate than those care teams in the standard of care arm without access to MEA.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

MEA is designed to increase adherence to consensus national guidelines and quality measures which are the standard of care for hyperlipidemia, atrial fibrillation, and heart failure. These diseases were selected based on national data which suggest there is less than optimal adherence to standard of care therapy and this non-adherence is associated with adverse cardiovascular outcomes.

There are 29 care teams in the Employee and Community Health (ECH) practice. Care teams are comprised of 4-8 clinicians who provide primary care to between 3,000 and 8000 patients. 8 care teams are resident/fellow led and will be excluded from the study. The remaining 21 care teams in the ECH practice will be stratified by clinic location and provider specialty (Internal Medicine, Family Medicine). 20 care teams will then be cluster-randomized to either the intervention arm or standard of care arm.

Prior to randomization, clinicians in both arms will receive the same educational module to the current guidelines for management of the atrial fibrillation, heart failure and hyperlipidemia. Clinicians in the intervention arm will receive training by the research team on the use of MEA. This training will clearly inform clinicians that they are always to use their best clinical judgment.

Study Type

Interventional

Enrollment (Actual)

2248

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Minnesota
      • Rochester, Minnesota, United States, 55905
        • Mayo Clinic in Rochester

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Clinician Inclusion Criteria:

  • Physicians
  • Assistants
  • Nurse Practitioners

Clinician Exclusion Criteria:

  • Clinicians providing care to nursing home patients
  • Pediatricians
  • Residents and fellows

Patient Record Inclusion Criteria:

  • Diagnosis of hyperlipidemia, atrial fibrillation, and/or heart failure

Patient Record Exclusion Criteria:

  • Unscheduled visits

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: MayoExpertAdvisor
Clinicians in care teams assigned to the intervention arm will have access to MayoExpertAdvisor (MEA) in the electronic medical record (EMR). MEA will provide patient-specific knowledge and treatment suggestions for patients with hyperlipidemia, atrial fibrillation, and/or heart failure via a clickable tab in the Mayo Clinic EMR.
Behavioral: MayoExpertAdvisor
Access to MayoExpertAdvisor (MEA) in the electronic medical record (EMR). MEA will provide patient-specific knowledge and treatment suggestions for patients with hyperlipidemia, atrial fibrillation, and/or heart failure via a clickable tab in the Mayo Clinic EMR.
No Intervention: Usual Care
Clinicians in care teams assigned to the standard of care arm will continue to provide up-to-date, patient-specific guideline-based treatment recommendations as is the standard of care at Mayo Clinic.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Percentage of pre-visit recommendations for hyperlipidemia acted upon by providers
Time Frame: Baseline to 6 months
Baseline to 6 months
Percentage of pre-visit recommendations for atrial fibrillation acted upon by providers
Time Frame: Baseline to 6 months
Baseline to 6 months
Percentage of pre-visit recommendations for heart failure acted upon by providers
Time Frame: Baseline to 6 months
Baseline to 6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Mayo Clinic

Investigators

  • Principal Investigator: Paul M McKie, M.D., Mayo Clinic

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2016

Primary Completion (Actual)

November 1, 2016

Study Completion (Actual)

November 1, 2016

Study Registration Dates

First Submitted

April 11, 2016

First Submitted That Met QC Criteria

April 18, 2016

First Posted (Estimate)

April 19, 2016

Study Record Updates

Last Update Posted (Actual)

April 18, 2019

Last Update Submitted That Met QC Criteria

April 16, 2019

Last Verified

April 1, 2019

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 15-008444

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Patient identifiers will be removed from the data prior to submission to the researchers.

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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