Technology-driven intervention to improve hypertension outcomes in community health centers

Journal Name: 
Am J Manag.Care
Authors: 
Shelley,D.
Tseng,T.Y.
Matthews,A.G.
Wu,D.
Ferrari,P.
Cohen,A.
Millery,M.
Ogedegbe,O.
Farrell,L.
Kopal,H.
Abstract: 
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
12
2011
Volume: 
17
Pages: 
SP103-SP110
Keywords: 
2010, adherence, Adult, Analysis of Variance, blood, Blood Pressure, Body Mass Index, clinical, community, Community Health Centers, Comparative Study, data, Databases,Factual, decision, Decision Support Systems,Clinical, Diabetes, Diagnosis, Drug Therapy, electronic, Electronic Health Records, evaluation, Family, Feedback, Female, Guidelines, Health, Humans, Hypertension, Income, information, instrumentation, Internal Medicine, intervention, Lead, Leadership, Logistic Models, medical, Medical Informatics, Medicine, Methods, Multicenter Studies, New York, organization & administration, patient, Patients, provider, Qualitative Research, quality, quality improvement, race, Record, regression, Research, Statistics as Topic, support, system, Time, Treatment Outcome, United States, Universities