Abstract 224: Implementation of an Actionable EHR-based Population Health Dashboard and Curriculum in a Cardiovascular Disease Fellowship

Abstract

Background: The advent of learning healthcare systems requires physicians to not only manage individual patients, but also use data to manage their patient population as a whole. Improving care using data has been facilitated via the adoption of the EHR and its ability to collate data for populations of patients. While incorporation of population health into residency curricula has become more common, there have been few educational initiatives for fellows despite the requirements of the ACGME that fellowship programs provide trainees with practice habit data relevant to their patient population. We aimed to create and evaluate an ambulatory cardiovascular disease fellowship population health dashboard and curriculum incorporating actionable, relevant metrics. Methods: In 2018 we developed a curriculum that taught principles of population health through didactics and videos that CVM fellows in our program could access asynchronously. In parallel, we developed a novel fellow-specific population health dashboard embedded in our EHR. The dashboard included demographic information relating to the fellow’s clinic patient population such as race/ethnicity, healthcare utilization information like percentage of no-show visits, and specialty specific quality metrics such as beta-blocker use in patients with CHF. CVM fellows (PGY4-7) participated in the effort. Fellows were encouraged to review their practices then coached by a CVM faculty member in one-to-one sessions to develop strategies to improve one or more quality metrics of their choice. Pre and post surveys were administered to determine baseline and post-curriculum knowledge, attitudes, and experience with the topic of population health. We tracked fellow engagement through measured dashboard utilization. Results: Pre and post survey response rate was 81% and 46% respectively. At baseline, 23.5% (8) of fellows reported never receiving any education in population health and 67.6% (23) of fellows reported previous experience with population health tools such as EHR dashboards. Only 14.7% (5) of fellows had baseline knowledge of how quality metrics affect health care reimbursement. After the initial year of the curriculum and dashboard implementation, 100% (11) of fellows responding believed that it was important to learn about population health management and planned to utilize the skills they learned in practice. Further, 72% (8) of fellows changed one or more aspects of their practice after utilizing the dashboard coupled with one-on-one coaching. Since EHR dashboard implementation, fellows have accessed the dashboard 560 times. Discussion: Integrating population health education utilizing a fellow-specific EHR dashboard in a CVM fellowship is both feasible and highly rated. This method of population health education is scalable across other cardiovascular disease fellowship programs and other subspecialties.