ALERT: Electronic Notifications Improve Management of AS, MR

The ALERT trial shows that automated electronic clinician notification alerts in the electronic health record (EHR) can meaningfully speed up the evaluation and treatment of patients with severe aortic stenosis (AS) or severe mitral regurgitation (MR). 

Conducted across 35 U.S. hospitals and published in JACC, the cluster‑randomized study found that clinicians who received EHR‑based alerts for significant AS or MR were more likely to schedule multidisciplinary heart‑team evaluation and valve intervention within 90 days than those receiving usual care.

Using a hierarchical win‑ratio analysis, the alert group had a win ratio of 1.27 (p = 0.007), with higher rates of valve intervention (13% vs. 10%) and multidisciplinary evaluation (23% vs. 18%), and shorter times to both endpoints. 

The benefit was similar for both AS and MR and across patient subgroups. The authors conclude that EHR‑integrated alerts are a practical, scalable way to reduce undertreatment of valvular heart disease and improve timely access to specialized valve‑disease care in routine clinical practice.