Journal article
A Technology-Based Quality Innovation to Identify Undiagnosed Hypertension Among Active Primary Care Patients
Annals of family medicine, Vol.12(4), pp.352-358
07/2014
DOI: 10.1370/afm.1665
PMCID: PMC4096473
PMID: 25024244
Abstract
PURPOSE The goal of this study was to develop a technology-based strategy to identify patients with undiagnosed hypertension in 23 primary care practices and integrate this innovation into a continuous quality improvement initiative in a large, integrated health system. METHODS In phase 1, we reviewed electronic health records (EHRs) using algorithms designed to identify patients at risk for undiagnosed hypertension. We then invited each at-risk patient to complete an automated office blood pressure (AOBP) protocol. In phase 2, we instituted a quality improvement process that included regular physician feedback and offce-based computer alerts to evaluate at-risk patients not screened in phase 1. Study patients were observed for 24 additional months to determine rates of diagnostic resolution. RESULTS Of the 1,432 patients targeted for inclusion in the study, 475 completed the AOBP protocol during the 6 months of phase 1. Of the 1,033 at-risk patients who remained active during phase 2,740 (72%) were classified by the end of the follow-up period: 361 had hypertension diagnosed, 290 had either white-coat hypertension, prehypertension, or elevated blood pressure diagnosed, and 89 had normal blood pressure. By the end of the follow-up period, 293 patients (28%) had not been classified and remained at risk for undiagnosed hypertension. CONCLUSIONS Our technology-based innovation identified a large number of patients at risk for undiagnosed hypertension and successfully classified the majority, including many with hypertension. This innovation has been implemented as an ongoing quality improvement initiative in our medical group and continues to improve the accuracy of diagnosis of hypertension among primary care patients.
Details
- Title: Subtitle
- A Technology-Based Quality Innovation to Identify Undiagnosed Hypertension Among Active Primary Care Patients
- Creators
- Michael K Rakotz - Feinberg School of Medicine, Northwestern University, Chicago, Illinois NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, The University of Chicago, Chicago, Illinois College of Medicine, University of Illinois, Chicago, Illinois Baylor College of Medicine, Baylor University, Houston, TexasBernard G Ewigman - Feinberg School of Medicine, Northwestern University, Chicago, Illinois NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, The University of Chicago, Chicago, Illinois College of Medicine, University of Illinois, Chicago, Illinois Baylor College of Medicine, Baylor University, Houston, TexasMenaka Sarav - Feinberg School of Medicine, Northwestern University, Chicago, Illinois NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, The University of Chicago, Chicago, Illinois College of Medicine, University of Illinois, Chicago, Illinois Baylor College of Medicine, Baylor University, Houston, TexasRuth E Ross - Feinberg School of Medicine, Northwestern University, Chicago, Illinois NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, The University of Chicago, Chicago, Illinois College of Medicine, University of Illinois, Chicago, Illinois Baylor College of Medicine, Baylor University, Houston, TexasAri Robicsek - Feinberg School of Medicine, Northwestern University, Chicago, Illinois NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, The University of Chicago, Chicago, Illinois College of Medicine, University of Illinois, Chicago, Illinois Baylor College of Medicine, Baylor University, Houston, TexasChad W Konchak - Feinberg School of Medicine, Northwestern University, Chicago, Illinois NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, The University of Chicago, Chicago, Illinois College of Medicine, University of Illinois, Chicago, Illinois Baylor College of Medicine, Baylor University, Houston, TexasThomas F Gavagan - Feinberg School of Medicine, Northwestern University, Chicago, Illinois NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, The University of Chicago, Chicago, Illinois College of Medicine, University of Illinois, Chicago, Illinois Baylor College of Medicine, Baylor University, Houston, TexasDavid W Baker - Feinberg School of Medicine, Northwestern University, Chicago, Illinois NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, The University of Chicago, Chicago, Illinois College of Medicine, University of Illinois, Chicago, Illinois Baylor College of Medicine, Baylor University, Houston, TexasDavid J Hyman - Feinberg School of Medicine, Northwestern University, Chicago, Illinois NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, The University of Chicago, Chicago, Illinois College of Medicine, University of Illinois, Chicago, Illinois Baylor College of Medicine, Baylor University, Houston, TexasKenneth P Anderson - Feinberg School of Medicine, Northwestern University, Chicago, Illinois NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, The University of Chicago, Chicago, Illinois College of Medicine, University of Illinois, Chicago, Illinois Baylor College of Medicine, Baylor University, Houston, TexasChristopher M Masi - Feinberg School of Medicine, Northwestern University, Chicago, Illinois NorthShore University HealthSystem, Evanston, Illinois Pritzker School of Medicine, The University of Chicago, Chicago, Illinois College of Medicine, University of Illinois, Chicago, Illinois Baylor College of Medicine, Baylor University, Houston, Texas
- Resource Type
- Journal article
- Publication Details
- Annals of family medicine, Vol.12(4), pp.352-358
- Publisher
- American Academy of Family Physicians
- DOI
- 10.1370/afm.1665
- PMID
- 25024244
- PMCID
- PMC4096473
- ISSN
- 1544-1709
- eISSN
- 1544-1717
- Language
- English
- Date published
- 07/2014
- Academic Unit
- Health Management and Policy
- Record Identifier
- 9984221744902771
Metrics
27 Record Views