Facilitated lipid management using interactive e-mail: preliminary results of a randomized controlled trial

Abstract

We describe the design and implementation of a clinical decision support system for ambulatory hyperlipidemia management. Despite readily available and evidence-based guidelines, cholesterol control remains persistently sub-optimal in clinical practice. "FastTrack" is an integrated, multi-faceted informatics tool to reduce barriers to effective cholesterol management by proactively integrating pertinent clinical information, evidence-based decision support and a simple means to act via a single FastTrack e-mail. We tested the intervention in a randomized, controlled trial involving 14 physicians and 276 patients. In an interim analysis, we found that physicians on average were able to review and act upon 9 patient e-mails in less than 15 minutes. Significantly more intervention patients were initiated on a statin therapy or had their dose increased (15.3% vs. 2.3%, p < 0.001). Impact of the intervention on LDL levels will be assessed at trial completion.