Supporting Use of AC Through Provider Profiling of Oral AC Therapy for AF

Nearly 1 million patients with atrial fibrillation (AF) who meet guideline criteria for
anticoagulation (AC) are being left untreated, often due to providers over-estimating risks
of bleeding and falling and under-estimating risks of stroke. The objective of this project
is to improve rates of adherence to AC guidelines by creating supportive and educational
materials for cardiology as well as primary care providers to evaluate the risks and benefits
of prescribing AC to patients with AF. The investigators will email providers individual
auto-updating reports containing their AC prescription rate compared to their peers and
compared to practice level AC prescription goal. This report will also contain a list of the
provider's AF patients who are eligible to receive AC based on their CHA2DS2-VASc stroke risk
score ≥ 2 and a list of eligible AF patients with upcoming appointments to focus providers on
an actionable group of patients with whom they might review the use of AC. The investigators
will also message providers through the EHR prior to an upcoming appointment with an eligible
patient reminding them to discuss AC if they deem appropriate. In addition, the investigators
will directly engage with providers through academic teledetailing to educate providers on AC
and address misconceptions and barriers to initiating or resuming AC in AF patients.

Inclusion Criteria:

- University of Massachusetts providers caring for patients aged 18 years and older with
ICD-10 diagnostic code consistent with AF or atrial flutter who had a visit with a
primary care provider or

- cardiovascular medicine specialist in the previous one year with the diagnosis of AF
present as an active diagnosis in the electronic medical record (EHR).

Exclusion Criteria:

- University of Massachusetts providers who do not care for patients aged 18 years and
older with ICD-10 diagnostic code consistent with AF or atrial flutter who had a visit
with a primary care provider or

- cardiovascular medicine specialist in the previous one year with the diagnosis of AF
present as an active diagnosis in the EHR.