Christine,
This is really well thought out, clear and concise. I really like the ideas Kevin and Adrienne propose in regards to some automated system for encouraging correct use and tracking said use. Another potential area for intervention would be targeting the patient’s Kevin mention, who have a low CHADS2 score initially, but subsequently developed increased scores over time. Perhaps a system that has an automated system that requires completion of a CHADS2 assessment yearly, or every other year as a part of routine follow-up.