Supplemental Support in Primary Care Can Improve Health

October 16, 2019

A study performed shows support of educational outreach, practice facilitation, and shared learning are more likely to achieve target blood pressure goals.

A new study, "A Randomized Trial of External Practice Support to Improve Cardiovascular Risk Factors in Primary Care" shares evidence that with supplemental support, primary care clinics can improve blood pressure care and lower the risk of cardiovascular disease.

Comagine Health participated in Healthy Hearts Northwest, an EvidenceNOW: Advancing Heart Health initiative, which aims to help smaller primary care practices effectively integrate evidence-based approaches to improving cardiovascular care outcomes, according to a report with Yahoo Finance.

The study team tested various combinations of strategies and support to discover which might improve performance on targeted clinical quality measures (CQMs) in 200 primary care clinics across Washington, Oregon, and Idaho.

Approaches included use of external practice facilitators, shared learning through site visits and virtual educational outreach. Study recruitment was limited to practices with 10 or fewer primary care providers per site and an electronic health record.

All enrolled clinics worked with a dedicated practice facilitator at their locations for over 15 months.

Some clinics were offered, through random selection, the added support of shared learning and educational outreach.

Smaller practices that received facilitation had modest improvements in their cardiovascular CQMs.

Those receiving the extra support of educational outreach, practice facilitation and shared learning were more likely to achieve target blood pressure goals, the study said.

Related:Community-based Care Model Reduces CVD Risk

"It became clear that smaller primary care clinics really valued the face-to-face time," Medical Director and Health Informatics, Jeff Hummel, MD, MPH, of Comagine Health, said. "They benefited from the additional learning and extra support."

The study measured improvements of four indicators known as "ABCS": aspirin therapy, blood pressure control, cholesterol management and smoking cessation. Coaches then worked side-by-side with providers on quality improvement projects that included creative ways to collect and evaluate ABCS data.

"We found that practices that were offered a coach plus additional support, such as opportunities to learn from similar clinics, were most likely to reach the goal of 70% or more of their patients achieving good blood pressure control (Million Hearts goal)," Senior Investigator, Michael Parchman, MD, MPH, of Kaiser Permanente Washington Health Research Institute, said in the report.

In a statement provided to Managed Healthcare Executive (MHE), Parchman says: “As clinics improved their quality improvement capacity, their performance on controlling blood pressure also improved.”

The study also resulted that clinics often struggled with getting clinical quality measure reports from their electronic health records. This often delayed their efforts to improve by many months, he tells MHE.

However, Parchman encourages other healthcare executives should be involved in this initiative because smaller primary care practices often struggle with improving clinical quality measures.

“The results of this study indicate that external support is needed and is effective,” he tells MHE