University of Wisconsin–Madison Medical College of Wisconsin

Impact of an Integrated Electronic Health Record Protocol on Inferior Vena Cava Filter Retrieval Attempt Rates: An Observational Cohort Study

Benjamin M. Parsons, DO; Sean R. O’Neil, MD; Andrew L. Horstman, PA-C; Mary C. Oldenburg, MS; Attila J. Kovacs, PhD; C. Isaiah Fitzmaurice, MS; Samuel Mosiman, MS; Tiana L. Carlson, BS

WMJ. 2025;124(2):91-95

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ABSTRACT

Introduction: To improve inferior vena cava (IVC) filter retrieval rates, an electronic health record prompt for scheduling retrieval before patient discharge was implemented.

Methods: This retrospective comparative cohort study was conducted in a single Midwestern tertiary care medical center. Adult patients with IVC filters placed for a medical (Medical subgroup) or trauma (Trauma subgroup) indication before and after protocol implementation and who had follow-up documented in the electronic health record were included. IVC filter retrieval attempt rates both overall and by indication for placement before and after protocol implementation were compared.

Results: Three hundred eighty-five patients met eligibility criteria: 223 before implementation (Before group) and 162 after implementation (After group). The attempted retrieval rate for the After group was 11.4% higher than the Before group (P = .012). Attempted retrieval rates in the Medical Before and After subgroups were 56.2% and 76.0%, respectively (P = .001). The Trauma subgroups’ rates were similar to each other (P = .594). Time to retrieval attempt was significantly shorter in the Medical After subgroup than in the Medical Before subgroup (P = .018) but similar in the Trauma subgroups.

Conclusions: Attempted retrieval rates were significantly higher in the After group and Medical After subgroup. Trauma subgroup rates were similar, likely because a previous intervention to increase retrieval in trauma patients was in place during the pre-implementation period of our study. Findings suggest that using an automated electronic health record-based prompt to facilitate IVC filter retrieval scheduling could greatly improve retrieval rates and patient safety.


Author Affiliations: Department of Medical Oncology, Gundersen Health System, La Crosse, Wisconsin (Parsons); Department of Medical Education, Gundersen Health System, La Crosse, Wisconsin (O’Neil); Department of Diagnostic Radiology, Gundersen Health System, La Crosse, Wisconsin (Horstman); Department of Research Navigation, Gundersen Health System, La Crosse, Wisconsin (Oldenburg, Kovacs, Fitzmaurice, Mosiman, Carlson); Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Mosiman); Medical College of Wisconsin, Milwaukee, Wisconsin (Carlson).
Corresponding Author: Benjamin M. Parsons, DO, Mail Stop EB2-001, Gundersen Health System, 1900 South Ave, La Crosse, WI 54601; phone 608.775.5937; email bmparson@emplifyhealth.org; ORCID ID 0000-0002-5634-2937
Financial Disclosures: None declared.
Funding/Support: None declared.
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