Table 2.
Identify therapeutic challenge | Establish team and deliverables | Patient education and support | Integration of IT | Measurement |
---|---|---|---|---|
Underuse of standard anticoagulation with warfarin | Apply lessons learned from coordinated care model | Modify content for patient education based on new service model | Adjust inputs in EHR beyond warfarin clinic support | Continue to identify appropriate patients who benefit from anticoagulation therapy based on risk criteria |
Emergence of newer anticoagulation | Translate focus of AF management to newer treatment options | Determine specific messages on range of options for anticoagulation therapy | Update EHR and smart sets to address current patient needs | Compare results from clinical trials to compare translation of potential benefit and harm |
Limited access of anticoagulation services | Expand clinical services to include vascular disease prevention often associated with AF | Expand access to include anticoagulation services, medication management, and vascular prevention | Broaden focus to include electrophysiology and general cardiology within a given practice environment | Determine value of AF and vascular prevention clinic across services within a cardiology practice |
Management of newer agents that may not require monitoring and monthly visits | Develop a schema for nonwarfarin anticoagulants and expand clinical services | Base patient visits on individual patient need and associated comorbidities | Set standards of care in AF patient population based on more comprehensive approach to care | Determine options to address improved overall outcomes as well as patient safety and satisfaction |
Abbreviations: EHR, electronic health record; AF, atrial fibrillation.