Partnership. Policy. Action.
Mid-year Membership Meeting
Celebrating World Hypertension Day
Policy, Program and System Change Strategies to
Improve Hypertension Control
May 17, 2017
Partnership. Policy. Action.
Welcome & Panelist Introduction
John M. Clymer
Executive Director
National Forum for Heart
Disease & Stroke
Prevention
2
Partnership. Policy. Action.
• Download today’s handouts by going to the
File menu in the upper left hand corner of
the screen. Select “Save Document.”
• We encourage you to submit written
questions at any time during the
presentation, using the Q&A Panel located
at the bottom right of your screen.
• Today’s session is being recorded.
Before We Begin
3
Partnership. Policy. Action.
• Welcome and Introduction to the Webinar Goal, Purpose, Objectives and Speakers
John Clymer
Executive Director, National Forum
• Featured Speaker
Mary McIntyre, MD, MPH
Alabama Department of Public Health
ASTHO Learning Collaborative
Finding Patients Hiding in Plain Sight
Agenda
4
Partnership. Policy. Action.
• Member Organization Speakers
– American Heart Association
Amy Ciarochi, HBP Strategic Alliances Manager
– Centers for Disease Control and Prevention
Judy Hannan, RN, MPH, Senior Advisor
Million Hearts®
– Consortium for Southeastern HTN Control
Debra Simmons, MS, RN, Executive Director
– World Hypertension League
Daniel Lackland, DrPH, President
Agenda
5
Partnership. Policy. Action.
• Updates
– 15th Annual Meeting
Laura Gordon, NF Secretary/Treasurer
– World Hypertension Day Thunderclap
John Clymer
• Q and A
• Closing
Agenda
6
Partnership. Policy. Action.
Finding Patients Hiding
in Plain SightMary McIntyre, MD, MPH
Chief Medical Officer
Alabama Department
of Public Health
“Hiding in Plain Sight”
7
•ASTHO’s Million Hearts Collaborative expressed a goal of preventing a million heart attacks in 5 years (2012-2017).
•Alabama was in the first group of 22 states selected for the Million Hearts Challenge.
•A new Million Hearts Challenge has been issued and runs from April 1,2017 to April 1, 2022.
The Goal…
Strategies
•Hiding in Plain Sight
•Self-Monitoring blood pressure
•Health Coaches
Alabama was the first state to adopt a statewideblood pressure protocol.
Million Hearts Collaborative
•First Collaborative between:Blue Cross Blue Shield of Alabama
Alabama Medicaid
Medicare-Cahaba Government Benefit Administrators, LLC
•Data Visualization Tool
Alabama Density of Hypertension by County
Blue Cross Blue Shield of Alabama
• Claims Data
• In-state members age 18-64
• July 2012 - June 2013
Perry County, followed by Madison Countyboth received the self-monitoring program with health coaches. Both did very well.
Mobile County had two staff in-services to raise awareness of diagnosing hypertension with their providers.
Intervention Counties
•69 Year Old Female, Insured, HTN with Diabetes•Baseline: 151/84 Average: 144/81
Chart Example
0102030405060708090
100110120130140150160170180190
1/2
1/1
4
1/2
4/1
4
1/2
7/1
4
1/3
0/1
4
2/2
/14
2/5
/14
2/8
/14
2/1
1/1
4
2/1
4/1
4
2/1
7/1
4
2/2
0/1
4
2/2
3/1
4
2/2
6/1
4
3/1
/14
3/4
/14
3/7
/14
3/1
0/1
4
3/1
3/1
4
3/1
6/1
4
3/1
9/1
4
3/2
2/1
4
3/2
5/1
4
3/2
8/1
4
3/3
1/1
4
4/3
/14
4/6
/14
4/9
/14
Mill
imet
ers
of
Mer
cury
Date of BP Reading
Blood Pressure Readings - #PC-AHA13CH
Systolic Diastolic
Self-Monitoring Results
148 138 91 860
102030405060708090
100110120130140150160
BaselineSystolic
CurrentSystolic
BaselineDiastolic
CurrentDiastolic
Mill
ime
ters
of
Me
rcu
ry
-6.8% -5.5%
Madison County
136 128 84 810
102030405060708090
100110120130140150160
BaselineLast ReadingBaselineLast Reading
Systolic
Diastolic
-6% -4%
Perry County
Mobile County Hiding in Plain Sight
71%
29%
Nov. 1, 2014 - May 31, 2015
Hypertension
Diabetes w/HTN
7.41%
12.49%
Newly Diagnosed Patients:Hypertension: 995Diabetes: 159
Alabama Department of HealthContact Information
•Brandi Pouncey, Hypertension/CV Program Manager
Email: [email protected]; Phone: (334) 206-5893
•Mary G. McIntyre, MD, MPH, Chief Medical Officer
Email: [email protected]://adph.org/cvh
Partnership. Policy. Action.
American Heart Association
Amy Ciarochi
HBP Strategic Alliances
Manager
American Heart Association
17
May 2017 – National HBP Education Month
• Collaboration with the World Hypertension League (WHL) to support their “Know Your Numbers” Campaign and contribute to the WHL goal of 25 million readings worldwide.
• AHA set a goal to reach 5 million blood pressure readings by May 17.
• Capture BP readings from April 17 – May 16.
• May 17th – World Hypertension Day AHA will make announcement on totals!
Target Audience
• Primary: People with HBP age 35 – 50• Secondary: African Americans & Hispanics
Overview
May 2017 – National HBP Education Month
• Toolkit developed and shared with staff and partners –includes approved messaging and design images
• Staff encouraged to engage with current partners. Get creative and have fun encouraging users to take BP during the campaign.
• Open Doors with new partners.
Rollout
May 2017 – National HBP Education Month
• BP Check totals –online tools and partners
• Radio Media Tour - April 26Managing High Blood Pressure
With Dr. Willie Lawrence
• Social Media Reach and Impressions
• Website Analytics
Campaign Results
www.heart.org/hbp
Hypertension Contacts @ NAT CTR
CommunicationsMaggie Francis214-706-1382
Marketing & ProgramsAmy Ciarochi214-706-1361
May 2017 – National HBP Education Month
Partnership. Policy. Action.
Centers for Disease Control and
Prevention
Judy Hannan, RN, MPH
Senior Advisor
Million Hearts®
Division for Heart Disease
and Stroke Prevention
Centers for Disease
Control and Prevention
22
CDC Efforts to Address Hypertension
• State, Local, and Tribal Heart Disease and Stroke
Prevention Programs in all 50 states and DC,
some local health departments and tribes
• WISEWOMAN programs in 19 states and two tribal
organizations
• Sodium Reduction in Communities Program in
eight communities
• Million Hearts® 2022
• Identifies and recognizes clinicians,
practices, and systems that achieved blood
pressure control for ≥70% of their
patients.
• Documents and brings attention to standard
and innovative system-level processes or
approaches used by high performers
• Improves understanding of successful
implementation strategies
• Motivates individual practices to strengthen
their hypertension control efforts.
“It’s about accountability
to our patients. We all
have a role to play in their
health.” —Andrew
Tremblay, MD, 2013 HTN
Control Champion
Million Hearts® Hypertension Control Challenge
Million Hearts® Hypertension Control Champions
• Since 2011, Million Hearts® has recognized 59 Hypertension Control
Champions achieving a blood pressure control rate of 70% or better.
• The Champions represent approximately 70,000 clinicians serving over
13.8 million patients (4.7 million with hypertension).
• The Champions have achieved an average blood pressure control rate of
78.2%.
• Champions used evidence-based strategies
• Hypertension treatment protocols
• Self-measured blood pressure monitoring
• Frequent check-in’s
• Registries and proactive outreach
• Team-based care.
• Action Guides http://millionhearts.hhs.gov/tools-protocols/action-guides.html
• Hypertension Control: Change Package for Clinicians
• Identifying and Treating Patients Who Use Tobacco: Action Steps for Clinicians
• Self-Measured Blood Pressure Monitoring: Action Steps for Clinicians
• Self-Measured Blood Pressure Monitoring: Action Steps for Public Health
• Medication Adherence: Action Steps for Public Health Practitioners
• Medication Adherence: Action Steps for Health Benefit Managers
• Cardiovascular Health: Action Steps for Employers
• Protocols http://millionhearts.hhs.gov/tools-protocols/protocols.html
• Hypertension Treatment Protocols
• Tobacco Cessation Protocols
• Cholesterol Management Protocols
26
Million Hearts® Resources
Million Hearts® Resources (cont’d)
• Clinical Quality Measures http://millionhearts.hhs.gov/data-reports/cqm.html
• Download the Million Hearts® measures
• Million Hearts® Clinical Quality Measures Dashboard
• Download the Data (HRSA UDS, NCQA HEDIS Commercial, NCQA HEDIS Medicaid, CMS PQRS Registry, CMS PQRS GPRO, CMS PQRS ACO)
• Tools http://millionhearts.hhs.gov/tools-protocols/tools.html
• Heart Age Calculator
• Hypertension Prevalence Estimator Tool
• ASCVD Risk Estimator
CALL FOR NOMINATIONS:2017 Million Hearts Hypertension Control Challenge
• Clinicians, practices, and health systems that have blood pressure
control rates at or above 70% are eligible to apply for the 2017
Challenge.
• Applications are accepted online through June 2, 2017
• Help us get the word out!
• Share this announcement
• Submit your nomination
• Encourage high-performing
practices to enter
More information available at https://millionhearts.hhs.gov/partners-progress/champions/challenge.html.
Send questions to [email protected].
Partnership. Policy. Action.
Consortium for Southeastern
Hypertension Control
Debra Simmons, MS, RN
Executive Director
Consortium for
Southeastern
Hypertension Control
29
“Eradicating Vascular Disease in All People” 30
“Eradicating Vascular Disease in All People”
Consortium for Southeastern Hypertension Control (COSEHC)
Driving Improvements in BP Management
“Eradicating Vascular Disease in All People”
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
6-8 years 10 years
82% 81%86% 82%
Baseline
Present
C l i n i c a l Q u a l i t y I m p r o v e m e n t
COSEHC AT GOAL PROGRAM Blood Pressure Control Rates-Southeast Region
Benchmark: 140/90 mmHg
“Eradicating Vascular Disease in All People”
30%
50%50%
60%56%
65%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Baseline (June 2016) Current (April 2017)
CHF
Diabetes
Optimal BP
17,615
86,222
250,550
Target
“Eradicating Vascular Disease in All People”33
C l i n i c a l Q u a l i t y I m p r o v e m e n t
• Teaching proper technique
• Using an HIT platform-Transparent Actionable Data
• Identifying and outreaching to patients who have not been seen, have not had
a risk factor measurement or their BP is out of range
• Provider reports and de-identified peer comparison reports
• Protocols with aligned standing orders empowering staff to address gaps
• Labs prior to appointments
• Ensuring BP is measured in every clinic visit (including specialists). Referral
of patients with pressure over 140/90 back to PCP
• Champion Leads to assist in achieving adoption
“Eradicating Vascular Disease in All People”34
C l i n i c a l Q u a l i t y I m p r o v e m e n t
PATIENT AND
FAMILY-CENTERED
CARE DESIGN
SUSTAINABLE
BUSINESS
OPERATIONS
CONTINUOUS,
DATA-DRIVEN
QUALITY
IMPROVEMENT
• Patient and family
engagement
• Enhanced access
• Accountability-
setting goal
• Shared decision-
making
• Quality
improvement
Culture
• Transparent
measurement and
monitoring
• Optimal use of HIT
• Huddles
• Capability to
analyze and
document value
• Operational
efficiency
• Entire healthcare
team engagement
Million Hearts
Partnership. Policy. Action.
World Hypertension League
Daniel Lackland, DrPH
Professor of
Epidemiology, Medical
University of South
Carolina; President, World
Hypertension League
35
Dedicated to the Assessment, Prevention, and Control of Hypertension Globally
The WHL is a charitable organization comprised of national and regional hypertension societies36
World Hypertension LeagueGoals and Vision
Our Goals:Optimize prevention and control of hypertension through collaborative work with member organizations, like-minded governmental and non-governmental partner organizations, evidence based interventions, and Best Practices. Committed to helping member organizations achieve 25-80% hypertension control depending on their resources and existing conditions.Our Vision:Hypertension prevention and control through joint efforts of national and regional leagues and societies and alliances with the World Health Organization (WHO), International Society of Hypertension (ISH), and other aligned organizations.
Dedicated to the Assessment, Prevention, and Control of Hypertension Globally
The WHL is a charitable organization comprised of national and regional hypertension societies37
World Hypertension LeaguePriorities
Prevent hypertension and its related vascular diseases by aiding efforts to reduce dietary salt (sodium).
Enhancing the control of hypertension by • Improving awareness of the diagnosis of hypertension• Aiding non governmental and governmental
organizations to take a cost effective strategic and systematic approach to hypertension control
Enhancing hypertension knowledge transfer between stakeholders
Dedicated to the Assessment, Prevention, and Control of Hypertension Globally
The WHL is a charitable organization comprised of national and regional hypertension societies38
World Hypertension LeagueImproving awareness of the diagnosis of
hypertension
World Hypertension Day (May 17th) dedicated to hypertension screening and diagnosis.
BP Screening resources for low resources settings Sustained committee to implement screening in low
resource settings. Recommendations for standardized reporting of blood
pressure surveys. Co-sponsor with International Society of Hypertension in
May Measurement Month
• 6.5 million blood pressures measurements reported globally!!!!!!
Partnership. Policy. Action.
2017 Annual Meeting
Laura Gordon
General Manager
Edelman
Secretary/Treasurer
National Forum
41
Partnership. Policy. Action.
2017 Annual Meeting
Paths to Engagement
• October 18, 2017
• 8:00 a.m. – 3:30 p.m. ET
• Barbara Jordan Conference Center,
Washington, DC
• Registration Open
https://www.eventbrite.com/e/national-forum-
15th-annual-meetingpaths-to-engagements-
tickets-34553915692
42
Partnership. Policy. Action.
World Hypertension Day
Thunderclap
43
Partnership. Policy. Action.
Thunderclap Results
44
Partnership. Policy. Action.
• We encourage you to submit written
questions using the Q&A Panel located at
the bottom right of your screen.
• After typing your questions in the space at
the bottom, hit the Send button.
• YOUR questions will not be seen by other
members of the audience, and will be
addressed, time permitting.
Q & A
45
Partnership. Policy. Action.
Closing & Contact Information
46
The National Forum for Heart Disease &
Stroke Prevention
1150 Connecticut AVE NW
Washington, DC 20036
www.nationalforum.org