Computed a return of investment of $160 per dollar spent, based on the average emergency department cost of a single cardiovascular disease event. Vision. However, such programs are less frequently integrated into the team-based care model and monitored by health care systems (5–7). It aims to contribute to public health planning in three broad ways. Balamurugan A, Adolph S, Faramawi M, George M, Zohoori N, Delongchamp R. Community team-based care for hypertension management: a public–private partnership in rural Arkansas. Provider perspectives on essential functions for care management in the collaborative treatment of hypertension: the P.A.R.T.N.E.R. Please enable scripts and reload this page. Public health programs to reduce risk of CHD. Ultimately, other funding streams and strategies such as health care payer reimbursement are needed to sustain these programs and take them to a national scale. Their use of a regional health information exchange provided real-time county-level rates of hypertension, hypertension control, and undiagnosed hypertension and is now a model for other state and territorial programs. The PDSA cycle allowed for rapid implementation, refinement of activities in the framework, and process improvement in a 10-month period. Oklahoma joined the collaborative during the third year (Phase 2) of implementation under an expansion of the initiative to address hypertension disparities in American Indian/Alaska Native populations. Examples include using electronic health record systems to drive identification of undiagnosed and uncontrolled hypertension; implementation of protocols for treatment, referrals, and follow-up to ensure clinical practices are standardized across public health; and formation of partnerships between community organizations and local clinics that help expand networks and self-management support. J Clin Hypertens (Greenwich) 2012;14(1):51–65. In 2013, the Centers for Disease Control and Prevention (CDC), Division for Heart Disease and Stroke Prevention, began a cooperative agreement with the Association of State and Territorial Health Officials (ASTHO), a national nonprofit organization representing public health agencies in the United States, the US territories, and the District of Columbia. New York. Logic model for ASTHO/CDC Heart Disease and Stroke Prevention Learning Collaborative. Hussain T, Allen A, Halbert J, Anderson CA, Boonyasai RT, Cooper LA. Because of their broad impact at the population level, a public health approach is needed to address the challenges of these common, critical and costly conditions. Data from electronic health records used to identify patients with uncontrolled hypertension for referral (counseling or management). ASTHO was able to accelerate the implementation process, while maintaining standards for quality improvement because of its ties with jurisdiction health leaders and historical success with multisector collaboratives (8,9). Read the article “Public Health Approach to Improve Outcomes for Congenital Heart Disease Across the Life Span.”. Each state used a comprehensive approach to improve hypertension identification and control by working across all 4 systems-change levers in our framework (Table). However, declines in death rates from heart disease have slowed, and additional action is needed to sustain progress and decrease the risk of illness and death associated with CVD (3). Too often, factors and circumstances that shape our health are devalued or ignored. Accessed January 30, 2019. Metrics developed with electronic medical record data; data registries used to track and contact patients; data system used to evaluate and report clinical outcomes. framework. In more severe forms of CHDs, blood vessels or heart chambers may be missing, poorly formed, and/or in the wrong place. Arkansas developed and tested well-defined hypertension care management plans in 4 counties, on the basis of a community team-based care approach that ultimately became the model for a standardized protocol that is now used statewide. The framework therefore takes not only a systems-strengthening approach but also a public health approach. Centers for Disease Control and Prevention. Email: [email protected] A learning collaborative to support state and territorial health agencies, health care systems, and community partners was developed to implement evidence-based practices for hypertension diagnosis and control across communities. between different public health needs. Learning collaborative states received modest additional funding through the learning collaborative, which was used to facilitate team building, expand data collection efforts, and support additional reporting requirements. Thirty-one state and territorial public health agencies participated in a learning collaborative to improve diagnosis and management of hypertension in clinical and community settings. Before their participation in the learning collaborative, states received direct funding from CDC to support their core heart disease and stroke prevention programs. Ford ES, Ajani UA, Croft JB, Critchley JA, Labarthe DR, Kottke TE, et al. JAMA Cardiol 2016;1(5):594–9. Blood pressure control is largely dependent on patient self-management programs. This learning collaborative illustrates how public health efforts are necessary to help prevent and control chronic disease by supporting interventions that focus on clinical outcomes associated with CVD. Epidemiology of obesity and diabetes and their cardiovascular complications. The framework is a method for working through these issues systematically and collaboratively. http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementTestingChanges.aspx. After an ASTHO-led Request for Proposal, states, tribal-serving organizations, and territories (jurisdictions) submitted proposals and were funded to develop a quality improvement process to improve hypertension diagnosis and control (Phase 1) (9). Core components of the model are summarized below. People born with a congenital heart defect and living with congenital heart disease have very different symptoms, risk factors, and quality of life. This publication was supported by grant no. This learning collaborative approach illustrates the importance of public health in the prevention and control of chronic disease by supporting interventions that address community and clinical linkages to address medical risk factors associated with cardiovascular disease. We applied the strategies used to implement the ASTHO/CDC framework in 3 states, each with a unique set of characteristics: New York, Oklahoma, and Arkansas (Table). Thirty-one state and territorial public health agencies participated in a learning collaborative to improve diagnosis and management of hypertension in clinical and community settings. In other words, nearly 40,000 infants in the U.S. are born with CHDs each year.