Electronic Alerts Improve Treatment Rates of Valvular Heart Disease
Joint UCSF-Massachusetts General Hospital study found that clinical providers who received notifications were more likely to recognize, diagnose and refer patients to specialists for aortic stenosis.
A new method of alerting clinical care providers holds promise for increasing treatment and improving survival for patients with severe aortic stenosis, a valvular heart condition that can be deadly when left untreated. Researchers from UC San Francisco and Mass General Brigham found that electronic messages sent to providers within one week of patients receiving an echocardiogram improved care for patients with severe aortic stenosis – including higher rates of treatment with aortic valve replacement (AVR), particularly in symptomatic patients.
Results are published in Circulation and presented at the 2025 American College of Cardiology’s Annual Scientific Session and Expo.
“Aortic stenosis is deadly when not treated in a timely manner, yet its under-treatment is a widespread problem that is the focus of ongoing national quality improvement initiatives. Our study establishes electronic provider notifications as a simple and effective tool to help ensure that severe aortic stenosis is appropriately recognized and treated,” said senior author Sammy Elmariah, MD, MPH, an interventional cardiologist and chief of Interventional Cardiology at UCSF, who began the study while working at Massachusetts General Hospital.
The researchers conducted a randomized, controlled clinical trial of 940 patients at Mass General Brigham with likely severe aortic stenosis. They enrolled 285 providers who had ordered an echocardiogram for their patients. Providers were randomly assigned to receive electronic notifications highlighting the detection of severe and potentially severe aortic stenosis or were assigned to a usual care arm of the trial.
Researchers report that rates of AVR within one year were higher for the patients under the care of providers who received the notification: 48% of patients compared to 37%. Patients under the care of notified providers lived on average 12 days longer than those in the usual care arm. More patients in the notification arm were also referred to specialists and received confirmatory diagnostic testing.
“Using data from our health care system, we were able to evaluate if a simple intervention – electronic messages sent through medical records and email – could improve care for patients with severe aortic stenosis,” said Varsha Tanguturi MD, of the Division of Cardiology at Massachusetts General Hospital, a founding member of the Mass General Brigham health care system. “We found that electronic notifications improved rates of AVR, particularly in the elderly and in women, and improved survival for patients.”
Additional Authors: Roukoz Abou-Karam, Fangzhou Cheng, Ignacio Inglessis, Nathaniel Langer, Evin Yucel, Jonathan Passeri, Judy Hung and Rong Duan.
Funding Disclosures: Elmariah has received research grants from the American Heart Association (19TPA34910170), National Institutes of Health (R01 HL151838), Edwards Lifesciences, Abbott Vascular, and Medtronic; he has received consulting fees from Edwards Lifesciences; and holds equity in Prospect Health. Tanguturi is a co-principal investigator of a grant funded by Edwards Lifesciences for the institution. Abou-Karam reports receiving consulting fees from Goodpath.