- Created by Kim Ball, last modified by Melissa Christian on Aug 25, 2023
Project Overview
Problem:
- Hypertension affects 115 million adults in America.
- 85% of Black 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.
Quick Links
HTN Use Case Updates:
View a recording and meeting notes of our August CardX Public Meeting Here
Register for our November CardX Public Meeting on 11/6: Here
HTN Use Case Resources:
CardX - Hypertension (HTN) Management (Member page)
Hypertension Management One-Pager
Meeting Cadence
Meeting | Description | Time |
---|---|---|
CardX Public Meetings | Sharing quarterly updates on the CardX Domain and Hypertension Management Use Case and open discussions to ask questions, provide insight into the progression of the use case. | Quarterly, typically on a Monday from 1pm-2pm ET |
CardX HTN Use Case Leadership Meeting | Convening of the decision-making body for the Use Case to align on priorities and finalize next steps for the Use Case. | Bi-weekly, Mondays from 1pm -2pm ET |
CardX HTN Use Case Team Planning Meeting | Discuss challenges, opportunities, next steps, and develop critical mass on subtopics for the HTN management use case | Thursdays 11am-12pm ET (weekly, alternating with Technical meetings) |
CardX HTN Use Case Team Technical Meeting | Review and discuss details of the technical specification. Develop critical mass on technical requirements for the specification and related artifacts. | Thursdays 11am-12pm ET (weekly, alternating with Planning meetings) |
Project Plan
COMPLETE IN PROGRESS DELAYED
Phase | Milestone | Timeline |
---|---|---|
Discovery | Use case identification
Convening of use case members
| July 2022 - March 2023 |
Planning | Plan out high-level project plan, deliverables, success measures, high level timeline, key stakeholders with consensus from the CardX community
Growing the CardX Community
| March 2023 - IN PROGRESS |
Execution Phase 1 | Proof-of-Concept
| September 2023 - January 2024 IN PROGRESS |
Execution Phase 2 | Pilot with CHC
| February 2024 - May 2024 |
Use Case Leadership Team
Role | Name | Organization |
Champion | James Tcheng, MD | University of Nebraska Medical Center - Center for Intelligent Health Care |
Champion | Hilary Wall | CDC Million Hearts |
Champion | John Windle, MD | University of Nebraska Medical Center - Center for Intelligent Health Care |
Use Case Lead | Melissa Christian, RN | University of Nebraska Medical Center - Center for Intelligent Health Care |
Use Case Support | Karen Bates | MITRE |
Terminologist | Tom Windle and Monique van Berkum | University of Nebraska Medical Center - Center for Intelligent Health Care and AMA |
Government Agency | Maria Michaels | CDC |
Payer | David Brick, Ellen Anderson, Paula Minnesota | Evicore |
Device Manufacturer | Andy Iverson | Medtronic |
EHR Vendor | Will Dark, Daniel Rutz | Epic |
Medical Society | Maria Isler, Sara O'Kane | AHA |
Medical Society | Corey Smith, Monique van Berkum | AMA |
Medical Society | Richard Kovacs, MD | ACC |
EHR Vender | Heather Dewhirst | Oracle/Cerner |
If you'd like to learn more about this use case, please contact Melissa Christian (melchristian@unmc.edu) or Karen Bates (kbates@mitre.org).
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