Project Summary: Dissemination and Implementation of QT Risk Clinical Decision Support. Clinical decision support (CDS) for electronic health records (EHR) and prescribing systems has beenpromoted to improve patient outcomes. Torsades de Pointes (TdP) is a life-threatening arrhythmiaassociated with the prolongation of the heart rate-corrected QT (QTc) interval on the electrocardiogram (ECG).Specifically TdP is polymorphic ventricular tachycardia preceded by QTc prolongation and usually manifestingas short bursts of ventricular contractions between 160 and 250 beats per minute that occur in rapidsuccession. A QTc Risk Score (QTc-RS) CDS can calculate the risk for QTc prolongation and assist doctorsand other healthcare providers in mitigating the risk of TdP. The central hypothesis of this project is that the dissemination and implementation of a CDS algorithmincorporating the QTc-RS will result in fewer instances of drug-induced prolonged QTc interval reduce thenumber of excessive lengths of stay and potentially lead to fewer sudden cardiac deaths. This proposaldescribes a health information technology research project aimed at the dissemination andimplementation of the QTc-RS in a non-profit network of 28 facilities located in five western states thatserve rural and urban communities. These facilities are located in regions of the Rocky Mountain west thathave a high proportion of underserved American Indian Latino and economically disadvantaged populations.We will accomplish our objectives by pursuing the following aims: Aim 1: Adapt implement and disseminate aQTc-RS CDS in rural and urban facilities across varying acuity levels within inpatient care facilities;Aim 2: Develop and deliver an educational program on QTc interval prolongation Torsades de Pointes andthe QTc interval prolongation risk score CDS to health professionals practicing in in-patient environments;Aim 3: Evaluate the effectiveness of a QTc-RS clinical decision support with respect to process changes withinfacilities patient focused clinical outcomes and end-user satisfaction. The proposed project will reduce the risk of QTc prolongation among vulnerable patients whilesimultaneously ensuring that providers are not overburdened with irrelevant warnings. We recognize thatsuccessful CDS implementation requires education and ongoing support. The educational aspects of thisproject will provide context and rationale for the risk score using a multi-faceted program that will ensure thatdissemination and implementation is long-lasting. This project will greatly improve patient safety and improvehealth care processes by incorporating real-time contextual factors into evidence-based and validated alertalgorithms that meet the five rights of meaningful CDS. In summary the project supports the mission of theAgency for Healthcare Research and Quality by improving the quality of healthcare and enhancing patientsafety in rural underserved and minority populations.