Example #1 (integrated into procedure note):

“Shared decision-making was facilitated in this visit by use of the University of Colorado decision tool.”

Example #2 (added to end of EPIC smartphrase):

Implantable Cardioverter Defibrillator (ICD) Preprocedure Checklist

Device to be implanted:  Biventricular ICD (New)

  • ICD indication: Primary prevention – Coronary artery disease with a prior MI on x (>40 days prior to ICD placement) and a LV EF of x% (</=30%) by a transthoracic echocardiogram (TTE).
  • Right atrial pacing indications: There is the expectation that this will improve cardiac efficiency and quality of life (e.g., in a patient with heart failure).
  • Left ventricular pacing indications: Ischemic cardiomyopathy with LV EF of x% (</= 30%) by a transthoracic echocardiogram (TTE), sinus rhythm, non-LBBB, QRS duration of x (>/=150) msec, and NYHA class III heart failure on guideline-directed medical therapy (GDMT).

None of the following is present:

  • NYHA class IV nonambulatory heart failure
  • Cardiogenic shock or symptomatic hypotension in a stable baseline rhythm
  • Coronary revascularization within the past 3 months
  • Clinical symptoms or signs that would make them a candidate for coronary revascularization
  • Non-cardiac disease associated with an expected survival of <1 year
  • Irreversible brain damage from preexisting cerebral disease

The Colorado Patient Decision Aid shared decision making tool was used.