Electronic Provider Alerts Improve Treatment Rates of Valvular Heart Disease

Valvular Heart Disease: A new method of alerting clinical care providers holds promise for increasing treatment and improving survival for patients with severe aortic stenosis (AS), a valvular heart condition that can be deadly when left untreated.Researchers from UC San Francisco (UCSF) 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 AS — including higher rates of treatment with aortic valve replacement (AVR), particularly in symptomatic patients.

The results are published in Circulation and presented at the 2025 American College of Cardiology’s Annual Scientific Session & 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 AS 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 AS. 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 AS 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 percent of patients compared to 37 percent. Patients under the care of the notified providers arm 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 healthcare 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 AS,” said Varsha Tanguturi MD, of the Division of Cardiology at Massachusetts General Hospital, a founding member of the Mass General Brigham healthcare system. “We found that electronic notifications improved rates of AVR, particularly in the elderly and in women, and improved survival for patients.”