Comagine Health and Healthy Hearts Northwest Improve Cardiovascular Care in Small Primary Care Clinics

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New Study Shows How Supplemental Support Bolsters Results

A new study, “A Randomized Trial of External Practice Support to Improve Cardiovascular Risk Factors in Primary Care” shares evidence that with supplemental support, primary care clinics can improve blood pressure care and lower the risk of cardiovascular disease.

A new study, “A Randomized Trial of External Practice Support to Improve Cardiovascular Risk Factors in Primary Care” shares evidence that with supplemental support, primary care clinics can improve blood pressure care and lower the risk of cardiovascular disease. The study was published in the Annals of Family Medicine. Comagine Health participated in Healthy Hearts Northwest, an EvidenceNOW: Advancing Heart Health initiative, which aimed to help smaller primary care practices effectively integrate evidence-based approaches to improving cardiovascular care outcomes.

The study team tested various combinations of strategies and support to discover which might improve performance on targeted clinical quality measures (CQMs) in 200 primary care clinics across Washington, Oregon and Idaho. Approaches included use of external practice facilitators, shared learning through site visits and virtual educational outreach. Study recruitment was limited to practices with 10 or fewer primary care providers per site and an electronic health record.

All enrolled clinics worked with a dedicated practice facilitator or “coach” at their locations over 15 months. Some clinics were offered, through random selection, the added support of shared learning and educational outreach. Smaller practices that received facilitation had modest improvements in their cardiovascular CQMs. Those receiving the extra support of educational outreach and shared learning were more likely to achieve target blood pressure goals.

“It became clear that smaller primary care clinics really valued the face-to-face time,” said Jeff Hummel, MD, MPH, Comagine Health’s medical director of health informatics said. “They benefited from the additional learning and extra support.”

The study measured improvements of four indicators known as “ABCS”: aspirin therapy, blood pressure control, cholesterol management, and smoking cessation. Coaches then worked side by side with providers on quality improvement projects that included creative ways to collect and evaluate ABCS data.

“We found that practices that were offered a coach plus additional support, such as opportunities to learn from similar clinics, were most likely to reach the goal of 70 percent or more of their patients achieving good blood pressure control,” said Healthy Hearts Northwest principal investigator Michael Parchman, MD, MPH, a Kaiser Permanente Washington Health Research Institute senior investigator and the paper’s lead author.

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About Comagine Health

Comagine Health, formerly Qualis Health and HealthInsight, works collaboratively with patients, providers, payers and other stakeholders to reimagine, redesign and implement sustainable improvements in the health care system. As a trusted, neutral party, we work in our communities to address key, complex health and health care delivery problems. In all our engagements and initiatives, we draw upon our expertise in quality improvement, care management, health information technology, analytics and research. We invite our partners and communities to work with us to improve health and redesign the health care delivery system. For more information, please visit http://comagine.org.

About Kaiser Permanente Washington Health Research Institute
Kaiser Permanente Washington Health Research Institute (KPWHRI) improves the health and health care of Kaiser Permanente members and the public. The Institute has conducted nonproprietary public-interest research on preventing, diagnosing, and treating major health problems since 1983. Government and private research grants provide the Institute’s main funding. For more information, please visit kpwashingtonresearch.org.

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Evan Stults
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