A Clinical Decision Support Tool for Familial Hypercholesterolemia Based on Physician Input

Mayo Clin Proc Innov Qual Outcomes. 2018 May 24;2(2):103-112. doi: 10.1016/j.mayocpiqo.2018.03.006. eCollection 2018 Jun.


Objective: To develop clinical decision support (CDS) for familial hypercholesterolemia (FH), based on physician input obtained by a mixed methods approach.

Introduction: Awareness, detection, and control of FH-a relatively common genetic disorder-is low. Clinical decision support could address knowledge gaps and provide point-of-care guidance for the management of FH.

Methods: A 16-question survey that assessed familiarity with FH and sought input on potential content of the CDS tool was emailed to 1161 clinicians including 208 cardiologists. In addition, 4 physician focus groups were held to gather input on the structure and form of the CDS tool. This study took place between September 12, 2016, and January 16, 2017.

Results: The response rate to the survey was 18.1%. Clinicians were overwhelmingly (97.6%) in favor of a CDS tool that assists in managing patients with FH at the point of care and this was confirmed in the focus group discussions. Key themes emerged during the focus groups including providers' knowledge and understanding of FH, facilitators and barriers to implementing a CDS tool, and suggestions for its design and content.

Conclusion: Clinicians were supportive of development of a CDS tool to assist with the evaluation and treatment of FH and provided feedback related to the design and implementation of such a tool.

Keywords: CDS, clinical decision support; CHD, coronary heart disease; EHR, electronic health record; FH, familial hypercholesterolemia; LDL-C, low-density lipoprotein cholesterol.