Improving Identification and Diagnosis of Hypertensive Patients Hiding in Plain Sight (HIPS) in Health Centers Margaret Meador, MPH, C-PHI, Jerome A.

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Presentation transcript:

Improving Identification and Diagnosis of Hypertensive Patients Hiding in Plain Sight (HIPS) in Health Centers Margaret Meador, MPH, C-PHI, Jerome A. Osheroff, MD, Benjamin Reisler, MPH Joint Commission Journal on Quality and Patient Safety Volume 44, Issue 3, Pages 117-129 (March 2018) DOI: 10.1016/j.jcjq.2017.09.003 Copyright © 2017 National Association of Community Health Centers Terms and Conditions

Figure 1 Detailed examples and images of several of the sample interventions are shown. Figure 1a: A prompt to the care team to address a potential undiagnosed hypertension/“hiding in plain sight” (HIPS) patient was integrated into an existing practice alert at one health center. The red text indicates an opportunity for the care team to act. Hovering over the text provides a brief explanation of why the patient may be a HIPS patient. Figure 1b: Two health centers used heart door magnets such as this one as a physical alert to cue providers that the patient waiting in the room for them had elevated blood pressure when his or her vital signs were taken. Figure 1c: Several health centers embedded the algorithm logic into automated pre-visit planning reports. In this report, elevated blood pressure readings are color-coded to red to indicate readings that are in the stage 2 hypertension range and color-coded yellow to indicate readings that are in the stage 1 hypertension range. Figure 1d: Several health centers used a flow sheet that graphically displayed historical blood pressure readings to understand whether patient patterns included multiple elevated blood pressure readings. Joint Commission Journal on Quality and Patient Safety 2018 44, 117-129DOI: (10.1016/j.jcjq.2017.09.003) Copyright © 2017 National Association of Community Health Centers Terms and Conditions

Figure 2 The columns depict patients in the undiagnosed hypertension longitudinal study group (patients identified by the hiding in plain sight (HIPS) algorithm as potentially undiagnosed for hypertension as of 1/31/2015), the proportion of the study group who had a follow-up visit, and the proportion of the study group who had both a follow-up visit and received a hypertension diagnosis, from January 2015 to June 2016. The curve represents the percentage of patients who received a hypertension diagnosis out of those who had a follow-up visit, from January 2015 to June 2016. Joint Commission Journal on Quality and Patient Safety 2018 44, 117-129DOI: (10.1016/j.jcjq.2017.09.003) Copyright © 2017 National Association of Community Health Centers Terms and Conditions