New Study Uses Electronic Health Record Data to Identify Hypertension in Patients from Underserved Communities

OAKBROOK TERRACE, Ill., Feb. 23, 2018 -- Although hypertension is the most common chronic condition among patients in health centers serving uninsured or underserved communities in the United States, many patients with the condition are not diagnosed and remain untreated, increasing their chances of developing heart disease and stroke. 

A new study in the March 2018 issue of The Joint Commission Journal on Quality and Patient Safety describes how 10 health centers with a high prevalence of hypertension in their patient population used electronic health record (EHR) analysis to identify patients potentially suffering from hypertension to ultimately improve their diagnoses.

In the article, “Improving Identification and Diagnosis of Hypertensive Patients Hiding in Plain Sight (HIPS) in Health Centers,” Margaret Meador, MPH, C-PHI, director, Clinical Integration and Education, National Association of Community Health Centers, Bethesda, Maryland, and co-authors, used a computerized algorithm to help staff identify patients with multiple elevated blood pressure readings. These patients were then contacted and brought in to determine if they needed treatment for hypertension.

After implementation of the algorithm-based interventions, diagnosed hypertension prevalence increased significantly from 34.5 to 36.7 percent. A cohort of patients was tracked from 8 of the 10 health centers to assess follow-up evaluation and diagnosis rates; 65.2 percent completed a follow-up evaluation, of whom 31.9 percent received a hypertension diagnosis. 

In an accompanying editorial, “Applying Population Health Approaches to Undiagnosed Hypertension,” Stephen D. Persell, MD, MPH, discusses how a population health strategy driven by EHR data is being used to address the diagnosis of hypertension in health centers that provide care to underserved populations and communities.

The article and editorial are available online free to the public. Also featured in the issue:

• “Empowering Informal Caregivers with Health Information: OpenNotes as a Safety Strategy” (Beth Israel Deaconess Medical Center, Boston)
• “When Clinicians Drop Out and Start Over after Adverse Events” (University of Massachusetts Boston)
• “Meeting Quality Measures for Adolescent Preventative Care: Assessing the Perspectives of Key Stakeholders” (Johns Hopkins University School of Medicine)
• “Highly Adoptable Improvement: A Practical Model and Toolkit to Address Adoptability and Sustainability of Quality Improvement Initiatives” (national expert panel)
• “Improving Quality of Care in Hospitals for Victims of Elder Mistreatment: Development of the Vulnerable Elder Protection Team” (New York-Presbyterian/Weill Cornell Medical Center, New York City)

For more information, visit The Joint Commission Journal on Quality and Patient Safety website.

Note for editors
The article is “Improving Identification and Diagnosis of Hypertensive Patients Hiding in Plain Sight (HIPS) in Health Centers” by Margaret Meador, MPH, C-PHI; Jerome A. Osheroff, MD; and Benjamin Reisler, MPH. The article appears in The Joint Commission Journal on Quality and Patient Safety, volume 44, number 3 (March 2018), published by Elsevier.

The editorial is “Applying Population Health Approaches to Undiagnosed Hypertension” by Stephen D. Persell, MD, MPH. The article appears in The Joint Commission Journal on Quality and Patient Safety, volume 44, number 3 (March 2018), published by Elsevier.

The Joint Commission Journal on Quality and Patient Safety
The Joint Commission Journal on Quality and Patient Safety (JQPS) is a peer-reviewed journal providing health care professionals with innovative thinking, strategies and practices in improving quality and safety in health care. JQPS is the official journal of The Joint Commission and Joint Commission Resources, Inc. Original case studies, program or project reports, reports of new methodologies or the new application of methodologies, research studies, and commentaries on issues and practices are all considered.

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