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- W4387249679 abstract "SESSION TITLE: Pioneering Pathways to Improve Quality SESSION TYPE: Original Investigations PRESENTED ON: 10/11/2023 08:30 am - 09:30 am PURPOSE: To evaluate the impact of an automated, electronic medical record (EMR)-integrated inferior vena cava (IVC) filter tracking system on filter use and retrieval rates across a large, US health care system with over 4.4 million members. METHODS: Retrospective chart review was performed for IVC filters placed in 22 Kaiser Permanente Northern California facilities between January 1, 2019 and January 1, 2020. Filters were identified using procedural codes. An automated IVC filter tracking system was constructed and implemented into the Kaiser Permanente Northern California EMR. A reporting workbench including filter plan, dwell time, and anticoagulation status was automatically generated for each facility. Retrieval was recommended <12 weeks from placement and ideally <9 weeks. The primary outcomes were rates of attempted IVC filter retrieval and successful retrieval. IVC filter indications and utilization were also evaluated. Statistical significance was calculated using the chi-squared test with p-values <0.05 considered to represent statistical significance. RESULTS: A total of 382 IVC filters were placed (47 permanent and 335 retrievable). 345 IVC filters placed (90.32%) fulfilled 2012 American College of Chest Physicians and 2011 Society of Interventional Radiology guidelines for filter indication. For retrieval statistical calculations, patients who died <12 weeks of filter placement (n=63) and patients with permanent-type filters (n=47) were excluded. 41 IVC filters (10.73%) were lost to follow-up. 169 of 209 potentially retrievable filters had attempted retrieval (80.1%). 165 filters were successfully retrieved (78.9%) and 152 filters were retrieved at first attempt (89.9%), a 97.6% overall retrieval success rate. Our prior 2016 study showed that within this healthcare system pre-intervention IVC filter retrieval rates were 38.9% which increased to 54% after education and implementation of a web-based tracking system. Using that study criteria, the automated EMR tracking system increased attempted retrieval rates +23.2% compared to pre-intervention (38.9% to 62.1%; p = 4.48x10-8, x2). It also showed an increase +8.1% of attempted retrievals compared to education and a web-based tracking system (54% to 62.1%; p = 0.065, x2). CONCLUSIONS: An automated, EMR-integrated IVC filter tracking system markedly improved IVC filter attempted retrieval rates (80.1%) compared to pre-intervention (38.9%) and a first-generation web-based tracking system (54.0%) across a large US healthcare region. CLINICAL IMPLICATIONS: Implementation of an EMR-integrated IVC filter tracking system was independently associated with improved IVC filter retrieval rates and attempted retrieval rates. This tracking system was built within a widely used EMR with potential to replicate it across other healthcare systems. DISCLOSURES: No relevant relationships by Kathy Chan No relevant relationships by Marc Flagg No relevant relationships by Gabriel Howles-Banerji No relevant relationships by Chi-Mei Liu No relevant relationships by Sudhir Rajan No relevant relationships by Paulina Sun No relevant relationships by Dongbin Todd No relevant relationships by Stephen Wang" @default.
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- W4387249679 date "2023-10-01" @default.
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- W4387249679 title "IMPACT OF AN AUTOMATED, ELECTRONIC MEDICAL RECORD-BASED INFERIOR VENA CAVA FILTER TRACKING SYSTEM ON RETRIEVAL RATES" @default.
- W4387249679 doi "https://doi.org/10.1016/j.chest.2023.07.2454" @default.
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