October 8, 2014

Reprinted from newswise.com

Although cardiovascular disease is largely avoidable through lifestyle modifications, it remains the nation’s number one cause of death. While annual wellness exams offer physicians the chance to advise patients on modifying cardiac risk factors, that advice can get lost easily, given the amount of information covered during a routine check-up.

Now, a team of biomedical informaticians, public health experts and primary care doctors from The Ohio State University (OSU) has found a way to give those heart health messages a boost by implementing a state-of-the-art electronic application (app) that could change the way physicians and patients interact with electronic health records (EHR).

Dr. Randi Foraker

Dr. Randi Foraker

One of the OSU researchers is Randi Foraker, PhD, Gillings School of Global Public Health epidemiology alumna, now assistant professor of epidemiology in OSU’s College of Public Health and of biomedical informatics in the OSU College of Medicine.

The app, called SPHERE (Stroke Prevention in Healthcare Delivery Environments), taps directly into an EHR system in real time and provides physicians and patients with an evaluation of cardiac disease risk. SPHERE transforms a patient’s personal health data into a color-coded cardiac scorecard that can be displayed on a tablet or laptop during the exam, giving physicians a powerful new communication tool.

Based on the American Heart Association’s (AHA) ‘Life’s Simple 7’  risk factors, the experimental app creates the scorecard by pulling patients’ risk factor data from multiple sources within the electronic health records system, using a “traffic light” color scheme to indicate if factors such as blood glucose, total cholesterol, body mass index and smoking status are at poor (red), intermediate (yellow) or ideal (green) levels.

While most of the scorecard is completed with the patient information, the program also allows physicians to manually input data about diet and physical activity, which are also ranked and color-coded. All of the information is combined into a global health indicator score ranging from 1 (red) to 100 (green).

Currently, SPHERE is being used exclusively at Ohio State’s point of care clinics with women over the age of 65. According to Foraker, this population tends to focus check-ups on topics other than cardiovascular disease – a key factor in why heart issues in women can go undiagnosed. Foraker says SPHERE was designed to change that.

“We developed SPHERE to be more than a static diagnostic or health calculator,” she said. “We wanted it to be a dialogue driver, with features that prompt patients and their physicians to change how they talk about and respond to cardiac risk factors.”

One of the features to which Foraker refers lets users adjust horizontal sliders to manipulate risk factor values, allowing them to visualize how lifestyle modifications could reduce – or increase –their chances of having a cardiovascular event.

“Suddenly all these numbers and values become tangible and motivational,” said Rebecca Jackson, MD, director of OSU’s Center for Clinical and Translational Science. “We can set weight and dietary goals on the slider and patients can see how their global health indicator changes from red to yellow to green.”

Foraker is first author on an April 8 article about the development of SPHERE, published in Contemporary Clinical Trials. She leads the study to evaluate SPHERE’s use in a primary care setting and also studies ways to bring SPHERE to a broader and younger patient population, noting that some risk factors are easier to change when modified earlier in life.

“Less than one percent of the American population is in optimal cardiac health,” Foraker said. “If SPHERE could help change that, it would be a major step towards stopping the epidemic. It also would show that when electronic health records connect people with data in meaningful ways, it does have the ability to impact care and outcomes.”


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Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or dpesci@unc.edu.

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