Clinical Trial Shows Electronic Provider Notifications Can Improve Rates of Treatment for Valvular Heart Disease

• Researchers found that clinical providers who received an alert were more likely to recognize, diagnose, and refer patients to specialists for aortic stenosis
• The randomized clinical trial involved more than 900 patients at Mass General Brigham 

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 Mass General Brigham and University of California San Francisco (UCSF) reported on the results of a randomized, controlled clinical trial of 940 patients at Mass General Brigham with likely severe AS. The researchers 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. Results are published in Circulation and presented at the 2025 American College of Cardiology’s Annual Scientific Session & Expo.

“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.”

To conduct their study, the research team 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 notified providers 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.

“Aortic stenosis is deadly when not treated in a timely manner, yet its undertreatment 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, who began work on the study while a member of the Division of Cardiology at MGH. Elmariah is now chief of Interventional Cardiology at UCSF.

Authorship: In addition to Tanguturi, Mass General Brigham authors include Roukoz Abou-Karam, Fangzhou Cheng, Ignacio Inglessis, Nathaniel Langer, Evin Yucel, Jonathan Passeri, and Judy Hung. Additional authors include Rong Duan.

Funding disclosures: Elmariah has received research grants from the American Heart Association (19TPA34910170), National Institutes of Health (R01 HL151838), Edwards Lifesciences, Svelte Medical, Abbott Vascular, and Medtronic; and has received consulting fees from Edwards Lifesciences. Tanguturi is a co-principal investigator of a grant funded by Edwards Lifesciences for the institution. Abou-Karam reports receiving consulting fees from Goodpath.

Paper cited: Tanguturi V et al. “Electronic Provider Notification to Facilitate the Recognition and Management of Severe Aortic Stenosis: A Randomized Clinical Trial” Circulation DOI: 10.1161/CIRCULATIONAHA.125.074470