Cook County Health in Chicago, which largely serves historically disenfranchised racial and ethnic populations, has been particularly hard hit by the COVID-19 public health crisis. Leaders in the public health system also started to realize that high blood pressure was another condition that required more care.
Cook County Health decided to start a trial AMA MAP BPTM program in the fall of 2020 to raise its overall BP-control rate, which was at roughly 40%. A six-month continuous quality improvement program, AMA MAP BP. Each element, which comprises an evidence-based strategy and action plan, supplementary tools and resources, practice coaching (facilitation of practice change), and performance indicators are shown on dashboards and in monthly reports and is executed for around two months.
The number of people with controlled blood pressure has been dropping for almost a decade, according to AMA President Jack Resneck, Jr., MD. "Even though it is widely acknowledged that uncontrolled blood pressure—the nation's No. 1 risk factor for heart attack, stroke, and premature death—contributes to nearly 850,000 deaths each year," he added. We are aware that the COVID-19 epidemic and other difficulties that many patients and physicians experience to make it challenging to successfully manage the illness.
The COVID-19 epidemic, according to Dr. Resneck, "also highlighted the glaring disparities that present in the U.S., including blood pressure regulation."
"Through the AMA MAP BP program, we will be able to help many more doctors, care teams, and healthcare organizations better partner with their patients to help them avoid the deadly consequences associated with high blood pressure—improving health outcomes for patients across the country," says the statement.
Seven months later, the AMA guided Cook County Health as it created its Cerner-embedded dashboard. At the same time, their technical team was getting ready to launch an online platform for mass vaccination registration at various locations across the Chicagoland region. In addition to aiding the creation and introduction of the MAP BP dashboard, the technical team was essential in helping the system vaccinate nearly one million residents, particularly those who live in our most vulnerable neighborhoods.
Since its adoption, the AMA MAP BP practice sites, which are now available at 11 practices, have witnessed a 13 percentage point improvement in blood pressure control.
Charles Edoigiawerie, MD, a family physician at Cook County Health, which offers treatment to more than 500,000 patients through the health system and health plan spanning two hospitals and more than a dozen community health centers, stated, "We knew that a lot of people will die if we don't do this.”
Given the several conflicting goals during an earlier, pre-vaccine period of the COVID-19 pandemic, here is how Cook County Health improved BP control.
Get to know patients where they are
"We spent the majority of our time contacting this patient population. During the pandemic, we had to explicitly go out to them and bring them back in,” according to Dr. Edoigiawerie.
To accomplish this, specialized teams visited patients' homes to check their blood pressure. The healthcare provider would provide the doctor with information on the patient's blood pressure after each house visit. But making sure that BP was measured accurately was crucial.
Dr. Edoigiawerie suggested that one method for achieving this goal was to have patients record and test their blood pressure many times at a clinic or home.
The emphasis is on how doctors and other medical professionals "manage blood pressure in the clinic."
To treat patients' blood pressure throughout the pandemic, Kesha Love, MSN, RN, a meaningful use analyst and technical trainer at Cook County Health, remarked that "seeing patients, where they were at home, helped us."
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