Presentation on theme: "The Million Hearts National Initiative Preventing one million heart attacks and strokes over five years A collaboration among the Missouri Department."— Presentation transcript:
1The Million Hearts National Initiative Preventing one million heart attacks and strokes over five yearsA collaboration among theMissouri Department of Health and Senior ServicesAmerican Heart AssociationPrimarisMissouri Primary Care AssociationMissouri Pharmacy Association
2What the National Initiative Means in Missouri If successful over five years, it will mean Million Hearts will have saved the lives ofapproximately 20,000 Missouriansenough people to fill up the Scottrade Center in St. Louis or the Sprint Center in Kansas City
3Missouri Quick FactsHeart Disease continues to be the leading cause of death.Stroke is now the fifth cause of death in Missouri.Prevalence of Hypertension is 34.3 in the general population and over 40 in the African-American population.Slightly more than half of those with hypertension are being told to decrease their sodium intake.Million Hearts is described as an activity in Missouri’s CDC 1305 Grant Domain 3 Strategy 12012 Provisional Vital Statistics and 2012 BRFSS. Death rates are higher in Missouri than in any other state in the U.S. Missourians have a significantly higher prevalence of chronic disease risk factors and conditions compared to Americans as a whole. Research has also found that African Americans have significantly higher rates of hypertension, obesity, and diabetes.
4Status of the ABCS Aspirin 47% Blood pressure 46% Cholesterol 33% People at increased risk of cardiovascular disease who are taking aspirin47%Blood pressurePeople with hypertension who have adequately controlled blood pressure46%CholesterolPeople with high cholesterol who are effectively managed33%SmokingPeople trying to quit smoking who get help23%The MH initiative focuses on the ABCS of prevention and our current compliance with these measures is dismal.Source: MMWR: Million Hearts: Strategies to Reduce the Prevalence of Leading Cardiovascular Disease Risk Factors --- United States, 2011, Early Release, Vol. 60
5Key Components of Million Hearts™ Community PreventionReduce the number of people who need treatmentClinical PreventionOptimize care for heart and stroke patientsTwo key components of the MH initiative that will help improve compliance with the ABCS are Community Prevention and Clinical Prevention.
6Health System Messages CliniciansEmphasize power of preventionCreate systems to get an “A” in the ABCSUse decision supports and registries to drive performanceDeploy teamsPharmacistsMonitor and influence refill patternsTeam upTeach adherence by helping patients to understand the importance of taking their medicationsTeach patients about the ABCS through Medication Therapy Management
7Health System Messages InsurersMeasure and incentivize performance on the ABCSCollect and share data for quality improvementEmpower consumersIndividualsKnow your numbers—and goalsGet to know the ABCSTake aspirin, if advisedTake steps to lower high blood pressure andcholesterolReduce sodium and trans fatsIf you smoke, quitAvoid exposure to second-hand smoke
8Timeline of progress in 2012 February - Bi-weekly teleconference planning sessions began - Press release introducing Million Hearts to public April - Letter to professionals released - Webinar presented by Dr. Janet Wright, HHS/CDC and Dr. Whaley-Connell HTN expert - Role of Million Hearts Physician Champion defined June - Nine Missouri physician champions recruited July - Missouri Millions Hearts regions defined as BRFSS regions August - Missouri Department of Health and Senior Services compiled data on Missouri cardiovascular disease - Missouri Million Hearts committee meets to review data Sept –Dec - Continued to add partners, MPCA and MPALaunched by HHS in Sept Missouri Million Hearts Collaboration timeline.BRFSS = Behavioral Risk Factor Surveillance Survey (explain here)MPCA= Missouri Primary Care AssociationMPA = Missouri Pharmacy Association
9Timeline of progress in 2013 Jan - March - Monthly teleconference planning sessions continue April - Presented at the MSMA meeting in KC - Gained interest from several physicians May - Face to Face meeting - Action Plan Developed for 2013/ Created work groups for identified plan objectives - Work groups convened November - Second Face to Face meeting October - Started project with MO HIE as a data resource for TGA Present - Total Ten Missouri physician champions recruited - 19 sites recruited to demonstrate The Guideline AdvantageWorking on a project with Missouri Health Connections to use them as a resource for data entry into the Guideline Advantage.TGA = The Guideline Advantage™
10Work Groups Communications (website/newsletter/media) Team care (Pharmacists/physicians)Provider Champion Recruitment and Resources and ToolsData Capture and Analysis (TGA)Baseline Data and Success measuresAdvocacy (Gov. relations)These workgroups have been established to implement the key strategic focus areas including Physician Champion Support, Patient Resource Support, Infrastructure for Communication (website, newsletters), Team Care focusing on the Physician –Pharmacist pertaining to medication adherence, Clinical Decision Support emphasizing the MH Clinical Quality Measures of the ABCS.TGA = The Guideline Advantage (American Heart Association, American Cancer Society and American Diabetes Association) quality improvement program for outpatient clinics and providers.
11Released a press release announcing the physician champions who volunteered for the initiative. Since then we have some new recruits. We have also changed this term to state “Provider Champion” to encompass all healthcare providers. Since then a couple have changed. We have some new ones and a couple that have withdrawn due to time availability.
12BRFSS RegionsBehavioral Risk Factor Surveillance System (BRFSS) is a telephone health survey system of healthcare consumerThe Behavioral Risk Factor Surveillance System (BRFSS) is the world's largest, on-going telephone health survey system
13Million Hearts Provider Champion Serves as an expert resource for the MO Million Hearts CollaborativePromotes the Million Hearts Initiative to health professionals and patientsEnhances knowledge on heart attack, stroke and related modifiable risk factors
14Million Hearts Provider Champion Supports local community-based patient-resources to reduce smoking prevalence, improve nutrition, reduce blood pressureSupports and reinforces healthy choices and healthy behaviors: Is aware of barriers to patient access to healthy choices and behaviorsPromotes the use of Health InformationTechnology
15Champion Resources Online Resources available on the Million Hearts website:Resource include informational articles and tools on:Aspirin therapyBlood pressureCholesterol managementSmoking cessationAnd much more.Million Hearts group developed a resource packet for providers and patients
16Behavioral Risk Factor Surveillance System (BRFSS) BRFSS is a state-level health survey that annually collects information on a range of issues including health conditions, risk behaviors, and preventive practices.BRFSS is used to:Indentify emerging health problems;Establish health objectives and track progress;Justify funding requests and report progress.
17Behavioral Risk Factor Surveillance System (BRFSS) MO Department of Health and Senior Services (DHSS) conducts the annual BRFSS with assistance and support of the Centers for Disease Control and Prevention(CDC)How is BRFSS conducted?Telephone interviews with adults over 18Only with those not living in institutionsHow many Missourians are interviewed?Approximately 6,360 are interviewed throughout the year.
18MISSOURI MILLION HEARTS 2012 BASELINE MEASURES These five measures are highlighted in Missouri to underscore the burden of heart disease and stroke, raise awareness of the ABCS for the prevention of heart attack and stroke and ultimately encourage the actual use of the ABCS for preventing heart attack and stroke by Physician Champion and all other health professionals. Our targets pertain only to heart attack and stroke ( reducing heart attack and stroke by 20, 000 by 2017) .2012 Provisional Vital Statistics and 2012 BRFSS . Death rates are higher in Missouri than in the U.S. Missourians have a significantly higher prevalence of chronic disease risk factors and conditions compared to Americans as a whole. African Americans have significantly higher rates of hypertension, obesity, and diabetes.4/5/2017
20Role of Missouri Dept. of Health and Senior Services Produce data from available sources such as BRFSS for Million Hearts.Provide Strategic Doing Expertise which enabled Missouri to establish strategic focus areas and workgroups for implementation.
21Role of Missouri Dept. of Health and Senior Services Partner with organizations representing disparate populations. (Missouri Primary Care Association for quality improvement initiatives on related measures e.g. high blood pressure, A1c, cholesterol.Initiate implementation of evidence based initiatives for quality improvement focusing on medication adherence. (e.g. add pharmacists to team based care)
22Role of Missouri Dept. of Health and Senior Services Promote Missouri Tobacco Quitline for quitting smoking, smoke-free policies, safe walking areas, and access to healthy food.Serve as the key leader in establishing the Sodium in Knowledge in Practice which is enabling Missourians to make better lower sodium food choices by focusing on education, policy change and environmental interventions.
23Role of Health Depts. and Community Organizations Work with health care systems to monitor national quality indicators, including “controlling high blood pressure,” and carry out quality improvements.Encourage health systems to use health information technology to identify patients who have high blood pressure and establish follow up systems tomonitor those patients.CDC VITAL SIGNS SEPTEMBER 2013
24Role of Health Depts. and Community Organizations Promote Missouri Tobacco Quitline for quitting smoking, smoke-free policies, safe walking areas, and access to healthy food.CDC VITAL SIGNS SEPTEMBER 2013
25Role of American Heart Association Provide evidence based guidelines for the treatment and prevention of stroke and heart diseaseProvide a multitude of resources for both consumers and providersEducational materialsHealth tracking toolsTools for professionalsQuality improvement programs
26Role of American Heart Association Provide link to physicians for support and expert opinionUtilize connections with the community to disseminate informationGain interest and support due to AHA brand name and credibility
27Role of Primaris Pilot Project with physician practices Develop a systems-level, data-driven approach to quality improvementPromote reporting and use of metrics to identify areas for clinical improvementAdvance Patient-Centered Medical Home efforts with emphasis on care management & transitions of care
28Role of Missouri Pharmacy Association Pilot Project with pharmacistsInform the public of the benefits of pharmacists as members of the health care teamPromote medication adherence as a key factor in health.
29Role of Missouri Primary Care Association One of our functions is assisting Federally Qualified Health Centers (a.k.a Community Health Centers) with quality enhancement and networking support of efforts to develop, implement, and sustain community health improvements.
30Role of Missouri Primary Care Association Quality Improvement/Performance ImprovementBest PracticesData CollectionResearch and AnalysisTechnical AssistanceNetwork DevelopmentPatient Centered Medical Home efforts with emphasis on population health and individual care management and carecoordination
31Program ModelProgram model for the Guideline Advantage (TGA). The MH task force Created a Missouri specific program module and are in the process of identifying funding for a pilot project using TGA.
32Tool for Population Health Management On-demand access to quality improvement data using a web-based toolAvailable physician-level reportingClinic and system aggregationTools for creating action listsThe Guideline Advantage Population Management Tool
33Tool for Population Health Management Alignment with key national initiativesNational and State benchmarkingPractice network opportunities, including virtual workshops and national recognition
34ContactsRobin Hamann American Heart Association Phone: (618)Kris Kummerfeld Heart Disease and Stroke PreventionPhone: (573) Abhi RayPrimarisPhone: (816)