| Technology-driven intervention to improve hypertension outcomes in community health centers. | |
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MedLine Citation:
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PMID: 22216768 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Objectives: To assess the impact of an electronic medical record (EMR) with clinical decision support (CDS) and performance feedback on provider adherence to guideline-recommended care and blood pressure (BP) control compared with a standard EMR alone. Study Design: Quasi-experimental with repeated measures. Methods: The study was conducted in a 4-site, federally qualified health center, Open Door Family Medical Centers, located in New York. The research team, Open Door leadership, providers, and staff developed and implemented a tailored multicomponent CDS system, which included a BP alert, a hypertension (HTN) order set, an HTN template, and clinical reminders. We extracted patient-level data for each encounter 17 months prior to implementation of the intervention (June 2007-October 2008) and 15 months post-intervention (April 2009-June 2010), from the EMR's data tables for all adult nonobstetric patients with a diagnosis of HTN (N = 3636). Results: Rates of HTN control were significantly greater in the post-intervention period compared with the baseline period (50.9% vs 60.8%; P <.001). Process measures, derived from the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Guidelines, also improved significantly. Logistic regression with generalized estimating equations showed that patients were 1.5 times more likely to have controlled BP post-intervention than pre-intervention. Correlates of poor BP control were black race, higher body mass index, diabetes, female gender, income, and a greater number of prescribed antihypertensive medications. Conclusions: Our findings suggest that health information technology that is implemented as part of a multicomponent quality improvement initiative can lead to improvements in HTN care and outcomes. |
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Authors:
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Donna Shelley; Tuo-Yen Tseng; Abigail G Matthews; Daren Wu; Pamela Ferrari; Asaf Cohen; Mari Millery; Olugbenga Ogedegbe; Lindsay Farrell; Helene Kopal |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of managed care Volume: 17 ISSN: 1936-2692 ISO Abbreviation: Am J Manag Care Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2012-01-05 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9613960 Medline TA: Am J Manag Care Country: United States |
Other Details:
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Languages: eng Pagination: SP103-10 Citation Subset: H |
Affiliation:
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227 East 30th St, Rm 608, New York, NY 10016. E-mail: Donna.shelley@nyumc.org. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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