ArticleCirculation. Cardiovascular quality and outcomes2023
Nationwide Implementation of a Population Management Dashboard for Monitoring Direct Oral Anticoagulants: Insights From the Veterans Affairs Health System.
Article in Circulation. Cardiovascular quality and outcomes, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 20 citations in OpenAlex.
- System-Wide, Electronic Health Record-Based Medication Alerts for Appropriate Prescribing of Direct Oral Anticoagulants: Pilot Randomized Controlled Trial.JMIR formative research · 2024Trial
- A qualitative evaluation of barriers and facilitators to a large-scale antithrombotic stewardship intervention in the United States Veterans Healthcare system.International journal of clinical pharmacy · 2025Article
- Safe and effective anticoagulation use: case studies in anticoagulation stewardship.Journal of thrombosis and haemostasis : JTH · 2025Review
- National rollout of a medication safety dashboard to improve testing for latent infections among biologic and targeted synthetic disease-modifying agent users within the Veterans Health Administration.Health services research · 2025Article
- Design and Implementation of a Dashboard for Drug Interactions Mediated by Cytochromes Using a Health Care Data Warehouse in a University Hospital Center: Development Study.JMIR medical informatics · 2024Article
- Article
- Pharmacist Use of a Population Management Dashboard for Safe Anticoagulant Prescribing: Evaluation of a Nationwide Implementation Effort.Journal of the American Heart Association · 2024Article
- A Pharmacist-Led Process to Monitor Discrepant Urine Drug Screen Results.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2024Article
- Digital dashboards for direct oral anticoagulant surveillance, intervention and operational efficiency: uptake, obstacles, and opportunities.Journal of thrombosis and thrombolysis · 2024Article
- Anticoagulation Stewardship to Bridge the Implementation Gap in Perioperative Anticoagulation Management.TH open : companion journal to thrombosis and haemostasis · 2024Review
- Strategies to enhance remote monitoring adherence among patients with cardiovascular implantable electronic devices.Heart rhythm O2 · 2023Article
- Digital dashboards for oral anticoagulation management: a literature scoping review.Journal of thrombosis and thrombolysis · 2023Article
- Role of Individual Clinician Authority in the Implementation of Informatics Tools for Population-Based Medication Management: Qualitative Semistructured Interview Study.JMIR human factors · 2023Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundDirect oral anticoagulants are first-line therapy for common thrombotic conditions, including atrial fibrillation and venous thromboembolism. Despite their strong efficacy and safety profile, evidence-based prescribing can be challenging given differences in dosing based on indication, renal function, and drug-drug interactions. The Veterans Health Affairs developed and implemented a population management dashboard to support pharmacist review of anticoagulant prescribing. The dashboard includes information about direct oral anticoagulants and dose prescribed, renal function, age, and weight, potential interacting medications, and the need for direct oral anticoagulant medication refills. It is a stand-alone system.
methodsUsing login data from the dashboard, nationwide implementation was evaluated using elements from the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework.
resultsBetween August 2016 and June 2020, 150/164 sites within the Veterans Health Affairs system used the dashboard, averaging 1875 patients per site. The dashboard was made available to sites on a staggered basis. Moderate or high adoption, defined as at least one login on at least 2 separate days per month, began slowly with 3/5 sites in the pilot phase but rapidly grew to 142/150 (94.7%) sites by June 2020. The average number of unique users per site increased from 2.4 to 7.5 over the study period. Moderate to high adoption of the dashboard's use was maintained for > 6 months in 126/150 (84.0%) sites by the end of the study period.
conclusionsThere was rapid and sustained implementation and adoption of a population health dashboard for evidence-based anticoagulant prescribing across the national United States Veterans Health Administration health system. The impact of this tool on clinical outcomes and strategies to replicate this care model in other health systems will be important for broad dissemination and uptake.
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