{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:58:11Z","timestamp":1782845891103,"version":"3.54.5"},"reference-count":16,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Med Inform"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Improving processes regarding the management of electronic health record (EHR) requests for chronic antihypertensive medication renewals may represent an opportunity to enhance blood pressure (BP) management at the individual and population level.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the effectiveness of the eRx HTN Chart Check, an integrated clinical decision support tool available at the point of antihypertensive medication refill request, in facilitating enhanced provider management of chronic hypertension.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The study was conducted at two Mayo Clinic sites\u2014Northwest Wisconsin Family Medicine and Rochester Community Internal Medicine practices\u2014with control groups in comparable Mayo Clinic practices. The intervention integrated structured clinical data, including recent BP readings, laboratory results, and visit dates, into the electronic prescription renewal interface to facilitate prescriber decision-making regarding hypertension management. A difference-in-differences (DID) design compared pre- and postintervention hypertension control rates between the intervention and control groups. Data were collected from the Epic EHR system and analyzed using linear regression models.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The baseline BP control rates were slightly higher in intervention clinics. Postimplementation, no significant improvement in population-level hypertension control was observed (DID estimate: 0.07%, 95% CI \u22124.0% to 4.1%;\n P<\/jats:italic>\n =.97). Of the 19,968 refill requests processed, 46% met all monitoring criteria. However, clinician approval rates remained high (90%), indicating minimal impact on prescribing behavior.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Despite successful implementation, the tool did not significantly improve hypertension control, possibly due to competing quality initiatives and high in-basket volumes. Future iterations should focus on enhanced integration with other decision support tools and strategies to improve clinician engagement and patient outcomes. Further research is needed to optimize chronic disease management through EHR-integrated decision support systems.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/70752","type":"journal-article","created":{"date-parts":[[2025,3,15]],"date-time":"2025-03-15T03:50:08Z","timestamp":1742010608000},"page":"e70752-e70752","source":"Crossref","is-referenced-by-count":1,"title":["Implementation of an Integrated, Clinical Decision Support Tool at the Point of Antihypertensive Medication Refill Request to Improve Hypertension Management: Controlled Pre-Post Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9319-5457","authenticated-orcid":false,"given":"John Charles","family":"Matulis 3rd","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9397-0107","authenticated-orcid":false,"given":"Jason","family":"Greenwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2777-1900","authenticated-orcid":false,"given":"Michele","family":"Eberle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9864-4393","authenticated-orcid":false,"given":"Benjamin","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8404-3248","authenticated-orcid":false,"given":"David","family":"Blair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1249-5656","authenticated-orcid":false,"given":"Rajeev","family":"Chaudhry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"issue":"3","key":"R1","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1136\/amiajnl-2011-000515","article-title":"Transmitting and processing electronic prescriptions: experiences of physician practices and pharmacies","volume":"19","author":"Grossman","journal-title":"J Am Med Inform Assoc"},{"issue":"2","key":"R2","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1177\/0897190018799217","article-title":"An examination of the prescription renewal process and implications for primary care physicians and community pharmacists","volume":"33","author":"Pattin","journal-title":"J Pharm Pract"},{"issue":"4","key":"R3","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1016\/j.sapharm.2018.06.003","article-title":"Workflow process mapping to characterize office-based primary care medication use and safety: a conceptual approach","volume":"15","author":"Steckowych","journal-title":"Res Social Adm Pharm"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-020-0221-y","article-title":"An overview of clinical decision support systems: benefits, risks, and strategies for success","volume":"3","author":"Sutton","journal-title":"NPJ Digit Med"},{"issue":"9","key":"R5","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.8206","article-title":"Clinical decision support systems for drug allergy checking: systematic review","volume":"20","author":"L\u00e9gat","journal-title":"J Med Internet Res"},{"issue":"5","key":"R6","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1370\/afm.233","article-title":"Impact of an evidence-based computerized decision support system on primary care prescription costs","volume":"2","author":"McMullin","journal-title":"Ann Fam Med"},{"issue":"11","key":"R7","first-page":"832","volume":"64","author":"Finley","journal-title":"Can Fam Physician"},{"issue":"2","key":"R8","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.030884","article-title":"Design and implementation of an electronic health record-integrated hypertension management application","volume":"13","author":"Funes Hernandez","journal-title":"J Am Heart Assoc"},{"issue":"10","key":"R9","doi-asserted-by":"publisher","first-page":"e143","DOI":"10.1161\/HYP.0000000000000232","article-title":"Implementation strategies to improve blood pressure control in the United States: a scientific statement from the American Heart Association and American Medical Association","volume":"80","author":"Abdalla","journal-title":"Hypertension"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.119.13437","article-title":"Future of hypertension: The need for transformation","volume":"74","author":"Dzau","journal-title":"Hypertension"},{"key":"R11","unstructured":"Muhlestein D Bleser WK Saunders RS McClellan M . All\u2010payer spread of acos and value\u2010based payment models in 2021: the crossroads and future of value\u2010based care. RAMAONHEALTHCARE. 2021. URL: https:\/\/ramaonhealthcare.com\/all-payer-spread-of-acos-and-value-based-payment-models-in-2021-the-crossroads-and-future-of-value-based-care\/ [Accessed 26-09-2024]"},{"key":"R12","unstructured":"Measure: controlling high blood pressure. Minnesota Department of Health. 2024. URL: https:\/\/www.health.state.mn.us\/diseases\/cardiovascular\/cardio-dashboard\/hbpcont.html [Accessed 26-09-2024]"},{"key":"R13","unstructured":"Controlling high blood pressure. National Quality Forum. 2024. URL: https:\/\/www.qualityforum.org\/Projects\/c-d\/Cardiovascular_Endorsement_and_Maintenance_2010\/0018_Controlling_high_blood_pressure.aspx [Accessed 26-09-2024]"},{"key":"R14","unstructured":"Data & Analytics. Epic Systems Corporation. 2024. 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