Vascular Health Assessment & Support Tool

The OSN-led Primary Care Working Group identified the Vascular Health Assessment and Support Tool (VHAST) with associated Vascular Health QI Toolkit as bold, practical, primary care innovations to enable QI in vascular health care. Building on a “Proof of Concept” model, the VHAST proposes to function within EMRs with embedded capability for clinical data to be compared in against best practice guidelines at point of care. The VHAST electronic tool will enable the integrated documentation and management of patients with confirmed vascular diseases and associated risk factors. It will only display data relevant to the disease(s) or risk factors selected.

Feasible & integrated specifications were developed for the following conditions:

Hypertension Diabetes Dyslipidemia PAD
MI/Angina CKD CHF Stroke/TIA

VHAST Opportunity for Innovation

The main gaps/challenges in providing quality vascular healthcare were identified by the OSN’s VHAST project team:
  • Growing burden of vascular diseases
  • Complex medical conditions
  • Disparate VH best practice care elements
  • Lack of integrated patient-centred VH case management
  • Lack of streamlined access to VH best practices
  • Non-standardized VH data
  • Limited access to real time patient & practice level outcomes’ reports

The VHAST Prototype

The prototype leveraged C-CHANGE (2014) clinical practice recommendations and included the following additional features:

  • Functions in OSCAR-an Ontario MD funding-eligible EMR offering- with the ability to pull existing data from OSCAR EMR
  • Verification of proof of concepts such as integrative functions and that there can be an improved iteration and control of transformation of the data such as categorizing medications
  • Architecture designed for scalability for all EMRs & additional chronic conditions
  • Complementary QI companion resources including QI Toolkit elements for hypertension screening & management and smoking cessation have been drafted

Throughout early development, primary stakeholders have demonstrated enthusiasm for the VHAST which aims to build capacity for patient-centred VH integration, CQI & clinical/patient decision support. Preliminary plans have been discussed for knowledge exchange, an evaluation framework, and sustainability. The OSN VHAST project team is continuing to strengthen connections with key collaborative partners & engaging with new partnerships to ensure alignment & promote end product efficiencies.

The VHAST prototype development was completed in September 2015 and usability testing by a select group of primary care providers was completed in October.

Next phase will be to create a fully functional VHAST Pilot version within OSCAR EMR that can be evaluated by a representative group of providers and allied health professionals within a variety of primary care models.