Determining Benchmarks for Hypertension Reduction

Introduction

The purpose of this project is to review the current quality measures for the management of hypertension. The condition is prevalent throughout the United States, which is problematic because it can lead one to develop other cardiovascular diseases. To that end, the author has gathered data regarding the incidence of the condition in the nation and analyzed it. Additionally, they have determined what current quality standards are for the management of hypertension and assessed them. They have also analyzed the information they have gathered and identified any concerns as well as ways in which these problems can be addressed. Lastly, they considered the matter of health information exchanges (HIEs) and how they interact with information quality. The findings of the analysis are presented in the report below and covered in the corresponding sections.

Overall, hypertension appears to be an increasingly prevalent problem nationwide, as the data gathered by the U.S. Department of Health and Human Services demonstrates. Per the Centers for Disease Control and Prevention (2021), 116 million, or 47.3%, of adults in the nation are affected by the condition. Most of them were taking prescription medications and implementing lifestyle modifications as recommended by their healthcare provider. The condition appears to increase in prevalence along with one’s age, and men appear to be slightly more at risk than women. Lastly, the Black population appears to have an elevated rate of hypertension, while Hispanic people have a substantially lower proportion of cases.

There is likely a number of reasons why the population has manifested the trends identified above. Overall, Americans are known for living unhealthy lifestyles that contribute to the development of heart disease. The differences between genders and ethnicities in terms of blood pressure have also been explored by numerous researchers. Overall, a reasonable benchmark appears to be the reduction of the hypertension case proportion in the population. The condition is caused in large part by one’s lifestyle, interventions for which can be applied in the public health domain. As such, it should be considered in terms of percentages, as the information is presented in that manner in most sources.

Quality Measures

Hypertension is a prominent condition that is continuously being researched and reviewed as various organizations try to establish best practices for preventing and managing it. As such, the information about quality measures is gathered and updated regularly on all levels, including national. As such, for the purposes of this report, the author gathered data from the American College Of Cardiology’s guidelines released in 2019. Casey Jr. et al. (2019) outline a set of criteria that relate to processes, structures, patient-centered approaches, a system of care implementations, and performance measure usage. The information was collected through a literature review, which was used to modify the existing guidelines released in 2011.

A variety of factors affect the quality measures in question, depending on the nature of the specific indicator. Some are dependent on the healthcare providers’ measurements of the patients’ blood pressure as an indicator of the overall hypertension situation in the population. As such, both patients and providers can affect them directly and indirectly. Others, such as the nonpharmacological interventions used, depend on the clinicians being assessed, as it is their choice as to which methods to adopt. Overall, the guidelines aim to assess a large number of factors and account for them when determining and analyzing quality measures.

Compatibility of Data

The project will assess more data than just the national trends in the future, for which purpose it will need to collect information from diverse sources. As such, the concern of compatibility emerges, as it may not be possible to combine information from different sources for analysis without performing some form of processing first. To ensure that it is compatible, it is first necessary to analyze how it is gathered and defined to determine what the differences are. Then, a unified data format should be created to that all of the information can be standardized and which can be analyzed effectively.

A variety of challenges can arise in the standardization of data, including different meanings of data, formats, and statistical analyses used. Per Oachs and Watters (2016), many providers use different data formats and proprietary software, which can make conversion problematic. Moreover, the information they collect can be stored using different measurement techniques or units, and some records may have information others lack. Sometimes, seemingly similar data may not represent the same condition, which, in the case of hypertension, can result from the condition’s definition being tied to different blood pressure levels. For successful combination and analysis, it is necessary to understand how each data source is organized and how it can be standardized.

Effects of Information Quality on the HIE

The purpose of a health information exchange (HIE) is to let healthcare workers and providers exchange patients’ information to ensure that they can provide them with appropriate treatments. While doing so, they seek to preserve the patient’s privacy and protect their information from leaking or being accessed inappropriately. The purpose of a national database is typically to assess the conditions of people throughout the country. As such, patient information is not provided, as it is unnecessary, and everyone is anonymized for subsequent analysis. More people can access a national database to use it for research, which is part of the reason why it preserves privacy.

If a facility submits inaccurate or incomplete information to an HIE, it endangers the patients whose data is included. The data may misrepresent or omit crucial points such as the patient’s medications or allergies, leading to inappropriate prescriptions. Among other issues, omissions in the patient’s medical issues may lead to a diagnosis not being recognized as such because the patient has manifested the condition before. Faulty submissions to a national database are associated with lower-danger, as it is not used to treat patients. Moreover, a single facility’s effects on the data will likely be minor to negligible. However, the inaccuracy is still introduced, and, with enough facilities contributing incorrect information, the overall analysis can show significant biases.

Conclusion

Overall, hypertension appears to be a prevalent issue in the United States, which is part of a continuing trend associated with Americans’ lifestyles and a variety of other factors. The condition is well-researched, and the AHA has formulated a comprehensive set of quality measures, which it regularly updates using the latest data. More information will be gathered for the initiative, and the author has reviewed the challenges they may encounter in standardizing it. Lastly, they have reviewed the differences between HIEs and national databases as well the effects errors in each can have. Overall, the project is now ready to proceed while addressing any potential problems effectively.

References

Casey Jr, D. E., Thomas, R. J., Bhalla, V., Commodore-Mensah, Y., Heidenreich, P. A., Kolte, D., Munther, P., Smith, S. C., Spertus, J. A., Windle, J. R., Wozniak, G. D., & Ziaeian, B. (2019). 2019 AHA/ACC clinical performance and quality measures for adults with high blood pressure: a report of the American College of Cardiology/American heart association Task force on performance measures. Journal of the American College of Cardiology, 74(21), 2661-2706.

Centers for Disease Control and Prevention. (2021). Hypertension cascade: Hypertension prevalence, treatment and control estimates among US adults aged 18 years and older applying the criteria from the American College of Cardiology and American Heart Association’s 2017 Hypertension Guideline—NHANES 2013–2016. Web.

Oachs, P. K., & Watters, A. L. (2016). Health information management: Concepts, principles, and practice (5th ed.). AHIMA Press.

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