Addressing Undertreatment and Health Equity in Aortic Stenosis Using an Integrated EHR Platform

Establish impact of automated alerts on the hierarchical composite endpoint of aortic valve repair/replacement (AVR) or follow-up visit with a multi-disciplinary heart team (MHT).

This multi-center, prospective, cluster-randomized controlled trial will evaluate Mpirik
 automated notifications as an intervention to support identification and evaluation of
 patients possibly indicated for Aortic Valve Replacement (AVR). This study will evaluate the
 impact of Mpirik automated notifications on: (1) AVR utilization (including time to AVR); and
 (2) multidisciplinary heart team clinic evaluation (including time to evaluation) for
 patients with definitive or possible severe AS on echocardiogram. These endpoints will also
 be examined within and between assigned groups according to race, ethnicity, sex, and
 geography.
 
 The primary question that will be answered:
 
 Do automated alerts sent to clinical providers decrease under-treatment of severe aortic
 stenosis?
 
 The study will compare the rate of clinical follow-up and aortic valve surgery in a control
 group (no alerts sent) to a treatment group (alerts sent to an appropriate care provider).