eVTE (Electronic Venous Thromboembolism): A Cluster, Randomized, Step-wedge Type II Hybrid Study of an Alert Recommending Extended Duration Thromboprophylaxis for At-risk Discharging Medical Patients to Prevent VTE.
A new algorithm derived from only patient age and components of the complete blood count and basic metabolic panel can identify patients discharged from the hospital who may benefit from a blood thinner (called rivaroxaban) to decrease their risk of blood clots, and for whom the risk of bleeding is minimal. The purpose of this study is to evaluate the use of a pop-up alert, which will be seen by clinicians when a discharging patient has been identified as being someone for whom the risk of blood clots is high, but for whom bleeding risk is estimated to be low. The pop-up alert will be enabled in a sequential fashion for each group of hospitals in 1 month blocks. We will look to see if the pop-up alert changes the number of patients who receive rivaroxaban. We will also measure the outcomes of blood clots and bleeding among all discharging patients.
• Discharging clinician must be in one of the following iCentra electronic health record (Cerner, Kansas City, MO) positions:
‣ Physician, nurse practitioner, or physician assistant hospitalist
⁃ Physician internal medicine
⁃ Physician family medicine
• Patient age ≥ 18 years.
• The encounter must be inpatient.
• A signed hospital discharge order must be present.
• eVTE target population criteria (increased venous thromboembolism risk, low bleeding risk) must be met