Feasibility Assessment for Implementation of Heart Failure Clinical Caremaps using Electronic Medical Records in Primary Practice

Objectives: The primary aim of this project is to evaluate the impact and level of use of Electronic Medical Records (EMRs) by family physicians (FPs) specifically with respect to HF management. This study provides pilot work towards successful implementation of HF clinical caremaps in EMRs to support decision making for FPs.Methods: A survey questionnaire was sent to 207 FPs from which 42 (20%) replies were received. The survey included questions on demographic information of the FP's practice, specifics about HF patients and their management, EMR use and whether they have improved management in HF patients.  Results: Among the 42 FPs who responded, 39 (93%) practice in the urban area of Hamilton and each have over 10 confirmed HF patients at their family practices, supporting the need for proper management of HF at the primary care level. FPs expressed concerns about difficulty in treating HF preserved vs. systolic HF, in managing HF patients with renal insufficiency and difficulty in the use of beta blockers. There was no consensus on whether EMRs have helped in improving the management of HF patients.Conclusions: There is a perceived need for management tools which can be integrated into EMRs to provide decision making support for FPs in managing HF.  Tools such as caremaps may help provide optimal care in managing HF patients as per the Canadian Cardiovascular Society guidelines.