@article{c086f47281d6446387a9716b657c8918,
title = "Leveraging the electronic health records for population health: A case study of patients with markedly elevated blood pressure",
abstract = "BACKGROUND: The digital transformation of medical data provides opportunities to perform digital population health surveillance and identify people inadequately managed in usual care. We leveraged the electronic health records of a large health system to identify patients with markedly elevated blood pressure and characterize their follow-up care pattern. METHODS AND RESULTS: We included 373 861 patients aged 18 to 85 years, who had at least 1 outpatient encounter in the Yale New Haven Health System between January 2013 and December 2017. We described the prevalence and follow-up pattern of patients with at least 1 systolic blood pressure (SBP) ≥160 mm Hg or diastolic blood pressure (DBP) ≥100 mm Hg and patients with at least 1 SBP ≥180 mm Hg or DBP ≥120 mm Hg. Of 373 861 patients included, 56 909 (15.2%) had at least 1 SBP ≥160 mm Hg or DBP ≥100 mm Hg, and 10 476 (2.8%) had at least 1 SBP ≥180 mm Hg or DBP ≥120 mm Hg. Among patients with SBP ≥160 mm Hg or DBP ≥100 mm Hg, only 28.3% had a follow visit within 1 month (time window of follow-up recommended by the guideline) and 19.9% subsequently achieved control targets (SBP <130 mm Hg and DBP <80 mm Hg) within 6 months. Follow-up rate at 1 month and control rate at 6 months for patients with SBP ≥180 mm Hg or DBP ≥120 mm Hg was 31.9% and 17.2%. CONCLUSIONS: Digital population health surveillance with an electronic health record identified a large number of patients with markedly elevated blood pressure and inadequate follow-up. Many of these patients subsequently failed to achieve control targets.",
keywords = "Electronic health records, High blood pressure, Hypertension, Quality of care, Risk factor, Surveillance",
author = "Yuan Lu and Chenxi Huang and Shiwani Mahajan and Schulz, {Wade L.} and Khurram Nasir and Spatz, {Erica S.} and Krumholz, {Harlan M.}",
note = "Funding Information: Dr Lu is supported by the National Heart, Lung, and Blood Institute (K12HL138037) and the Yale Center for Implementation Science. Dr Krumholz is a recipient of a research grant, through Yale, from Medtronic and the US Food and Drug Administration to develop methods for postmar-ket surveillance of medical devices; is a recipient of research agreements with Medtronic and Johnson & Johnson (Janssen), through Yale, to develop methods of clinical trial data sharing; works under contract with the Centers for Medicare & Medicaid Services, through Yale, to develop and maintain performance measures that are publicly reported; was a recipient of a research agreement, through Yale, from the Shenzhen Center for Health Information for work to advance intelligent disease prevention and health promotion, and collaborates with the National Center for Cardiovascular Diseases in Beijing; received payment from the Arnold & Porter Law Firm for work related to the Sanofi clopidogrel litigation and from the Ben C. Martin Law Firm for work related to the Cook inferior vena cava filter litigation; chairs a Cardiac Scientific Advisory Board for UnitedHealth; is a participant/participant representative of the IBM Watson Health Life Sciences Board; is a member of the Advisory Boards for Element Science and for Facebook, and the Physician Advisory Board for Aetna; and is the founder of Hugo, a personal health information platform. Dr Schulz is a consultant for Hugo, a personal health information platform. Dr Spatz receives support from the Centers for Medicare & Medicaid Services to develop and maintain performance measures used in public reporting programs and from the Food and Drug Administration to support projects within the Yale–Mayo Clinic Center of Excellence in Regulatory Science and Innovation. She also receives support from the National Institute on Minority Health and Health Disparities (U54MD010711-01) to study precision-based approaches to diagnosing and preventing hypertension and the National Institute of Biomedical Imaging and Bioengineering (R01EB028106-01) to study a cuffless blood pressure device. The remaining authors have no disclosures to report. Publisher Copyright: {\textcopyright} 2020 The Authors. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2020",
month = apr,
day = "9",
doi = "10.1161/JAHA.119.015033",
language = "English (US)",
volume = "9",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley",
number = "7",
}