Project Overview

Problem: 

• Hypertension affects 115 million adults in America.
  • 85% of African-Americans will develop hypertension in their lifetime.
• There is a lack of adherence to clinical guidelines to diagnose, treat, and manage hypertension.
  
  • Over 30% of people do not know that they have hypertension.
  • Only 25% of patients with a diagnosis of hypertension achieve blood pressure control.
• Home blood pressure monitoring is the standard for hypertension monitoring, however there are no standards to capture in the EHR.
  • There is a lack of open communication between patient-facing and clinician EHR systems
  • There is a lack of consistent vocabulary and associated data standards for data exchange
  • There is a lack of technical standards for interoperability between home blood pressure monitoring devices, EHR, and Personal Health Intermediaries.

Description: 

• Patients are recommended to use a home blood pressure monitoring system by clinicians and are instructed on how to correctly measure blood pressure at home
• From a device vendor gateway, home measured blood pressure data and metadata will be exchanged with a Personal Health Intermediary using a standard FHIR-based API
• Separate FHIR-based exchanges will connect the the Personal Health Intermediary with the EHR 
  • The Personal Health Intermediary will exchange data collected by the patient with the EHR that is relevant to clinicians
  • The EHR will provide relevant information gathered in the clinic to the Patient Health Intermediary to create a guidelines-based care plan

Goal:  

• Create integrated, automated, vendor-agnostic hypertension standards by developing FHIR resources and open APIs that enable interoperable, scalable, and accessible hypertension management both at home and in the clinic
• To improve the awareness of guidelines, identification of disease, and management of individuals with hypertension.
• Increase the proportion of individuals with hypertension who are treated to goal. 
• Define the methodology to enable data liquidity between home blood pressure measurement devices, Personal Health Intermediaries, and EHR devices.
• Harmonize HTN vocabulary (demographics, VS, diagnoses, assessments, labs, meds, care plan)
• Develop device data exchange standards (“plug and play”) for:
  • Home BP device data
  • Communication between patient-facing and clinician EHR systems

Potential Impact: 

• Provide patients, physicians, APPs, nurses, medical assistants, pharmacists, and dietitians with the tools needed to adhere to hypertension guidelines.
• Increase data liquidity between blood pressure measurements captured at home with those captured in the clinic.
• Personal Health Intermediaries will be able to easily send and receive data to enhance a patient's ability to be part of their own care team. 
• EHR vendors will enable a service that will help clinicians treat patients.

Meeting Cadence 

Project Plan

COMPLETE   IN PROGRESS  DELAYED

Use Case Leadership Team

If you'd like to learn more about this use case, please contact Melissa Christian (melchristian@unmc.edu) or Rute Martins (rute@mitre.org).