Exploring Which EHR Interventions Improve Heart Failure Hospitalization Outcomes Across 10 Hospitals.

BACKGROUND: Heart failure (HF) remains a major cause of mortality and hospitalization despite advances in guideline-directed medical therapy (GDMT). Electronic health record (EHR)-based clinical decision support tools may improve care delivery, but their impact on outcomes remains ill-defined. PROJECT RATIONALE: As part of a system-wide HF quality improvement initiative, we evaluated 2 EHR interventions: an evidence-based HF admission order set promoting early diuresis and GDMT optimization, and a templated HF documentation tool (HFNOTE) designed to capture clinical complexity. PROJECT SUMMARY: We analyzed 4,865 HF hospitalizations across 10 hospitals between December 2024 and June 2025. Overall risk-adjusted mortality index was 0.83 and 30-day readmission index was 1.07. Both admission order set and HFNOTE use were associated with lower mortality index compared to nonuse. Readmission indices were similar across groups. TAKE-HOME MESSAGE: Targeted EHR interventions were associated with lower risk-adjusted inpatient mortality with a limited impact on 30-day readmissions, warranting further analyses to determine causal effects.