Alerta electrónica para mejorar las pruebas de aldosteronismo primario en pacientes con hipertensión (ALERT-PA)

An on-screen electronic alert will be issued during the outpatient clinical encounter that notifies the clinician that their patient should be screened for Primary Aldosteronism and provides an order set for the corresponding laboratory evaluation. Details of the electronic alert are provided in the Intervention description.

For patients randomly assigned to the BPA Alert Group, an on-screen electronic alert will be issued during the outpatient clinical encounter than notifies the clinician that their patient should be screened for PA. The clinician will be provided with on-screen details of which patient-specific risk factors qualified them for PA screening and with an option to order a plasma renin activity, aldosterone, and basic metabolic panel. If screening labs are ordered, the clinician will also receive an option to order an eConsult for expert guidance on interpretation of the test results. If the clinician does not order the PA screening labs, they will be able to continue with clinical EHR documentation but will need to select a reason they opted not to follow the alert's evidence-based clinical practice recommendation.

No electronic alert will be issued in the No Intervention group. Providers will continue standard of care with their patients.

The primary outcome is the frequency of aldosterone/renin laboratory testing orders placed by providers.

Frequency of referral to specialist who may treat PA (endocrinology, cardiology, or nephrology)

Frequency of prescription of empiric MRA such as spironolactone, eplerenone, or finerenone

Frequency of new ICD Diagnostic Code for PA, Secondary Hypertension, or Endocrine Hypertension

Frequency of provider ordering an E-Consult with a PA-specialist

Frequency of a suppressed plasma renin activity <=1 and aldosterone >=7.5 among patients who are screened.