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Electronic Health Record–Driven Approaches in Primary Care to Strengthen Hypertension Management Among Racial and Ethnic Minoritized Groups in the United States: Systematic Review
BACKGROUND: Managing hypertension in racial and ethnic minoritized groups (eg, African American/Black patients) in primary care is highly relevant. However, evidence on whether or how electronic health record (EHR)–driven approaches in primary care can help improve hypertension management for patien...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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JMIR Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10541643/ https://www.ncbi.nlm.nih.gov/pubmed/37713256 http://dx.doi.org/10.2196/42409 |
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author | Ose, Dominik Adediran, Emmanuel Owens, Robert Gardner, Elena Mervis, Matthew Turner, Cindy Carlson, Emily Forbes, Danielle Jasumback, Caitlyn Lydia Stuligross, John Pohl, Susan Kiraly, Bernadette |
author_facet | Ose, Dominik Adediran, Emmanuel Owens, Robert Gardner, Elena Mervis, Matthew Turner, Cindy Carlson, Emily Forbes, Danielle Jasumback, Caitlyn Lydia Stuligross, John Pohl, Susan Kiraly, Bernadette |
author_sort | Ose, Dominik |
collection | PubMed |
description | BACKGROUND: Managing hypertension in racial and ethnic minoritized groups (eg, African American/Black patients) in primary care is highly relevant. However, evidence on whether or how electronic health record (EHR)–driven approaches in primary care can help improve hypertension management for patients of racial and ethnic minoritized groups in the United States remains scarce. OBJECTIVE: This review aims to examine the role of the EHR in supporting interventions in primary care to strengthen the hypertension management of racial and ethnic minoritized groups in the United States. METHODS: A search strategy based on the PICO (Population, Intervention, Comparison, and Outcome) guidelines was utilized to query and identify peer-reviewed articles on the Web of Science and PubMed databases. The search strategy was based on terms related to racial and ethnic minoritized groups, hypertension, primary care, and EHR-driven interventions. Articles were excluded if the focus was not hypertension management in racial and ethnic minoritized groups or if there was no mention of health record data utilization. RESULTS: A total of 29 articles were included in this review. Regarding populations, Black/African American patients represented the largest population (26/29, 90%) followed by Hispanic/Latino (18/29, 62%), Asian American (7/29, 24%), and American Indian/Alaskan Native (2/29, 7%) patients. No study included patients who identified as Native Hawaiian/Pacific Islander. The EHR was used to identify patients (25/29, 86%), drive the intervention (21/29, 72%), and monitor results and outcomes (7/29, 59%). Most often, EHR-driven approaches were used for health coaching interventions, disease management programs, clinical decision support (CDS) systems, and best practice alerts (BPAs). Regarding outcomes, out of 8 EHR-driven health coaching interventions, only 3 (38%) reported significant results. In contrast, all the included studies related to CDS and BPA applications reported some significant results with respect to improving hypertension management. CONCLUSIONS: This review identified several use cases for the integration of the EHR in supporting primary care interventions to strengthen hypertension management in racial and ethnic minoritized patients in the United States. Some clinical-based interventions implementing CDS and BPA applications showed promising results. However, more research is needed on community-based interventions, particularly those focusing on patients who are Asian American, American Indian/Alaskan Native, and Native Hawaiian/Pacific Islander. The developed taxonomy comprising “identifying patients,” “driving intervention,” and “monitoring results” to classify EHR-driven approaches can be a helpful tool to facilitate this. |
format | Online Article Text |
id | pubmed-10541643 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-105416432023-10-02 Electronic Health Record–Driven Approaches in Primary Care to Strengthen Hypertension Management Among Racial and Ethnic Minoritized Groups in the United States: Systematic Review Ose, Dominik Adediran, Emmanuel Owens, Robert Gardner, Elena Mervis, Matthew Turner, Cindy Carlson, Emily Forbes, Danielle Jasumback, Caitlyn Lydia Stuligross, John Pohl, Susan Kiraly, Bernadette J Med Internet Res Review BACKGROUND: Managing hypertension in racial and ethnic minoritized groups (eg, African American/Black patients) in primary care is highly relevant. However, evidence on whether or how electronic health record (EHR)–driven approaches in primary care can help improve hypertension management for patients of racial and ethnic minoritized groups in the United States remains scarce. OBJECTIVE: This review aims to examine the role of the EHR in supporting interventions in primary care to strengthen the hypertension management of racial and ethnic minoritized groups in the United States. METHODS: A search strategy based on the PICO (Population, Intervention, Comparison, and Outcome) guidelines was utilized to query and identify peer-reviewed articles on the Web of Science and PubMed databases. The search strategy was based on terms related to racial and ethnic minoritized groups, hypertension, primary care, and EHR-driven interventions. Articles were excluded if the focus was not hypertension management in racial and ethnic minoritized groups or if there was no mention of health record data utilization. RESULTS: A total of 29 articles were included in this review. Regarding populations, Black/African American patients represented the largest population (26/29, 90%) followed by Hispanic/Latino (18/29, 62%), Asian American (7/29, 24%), and American Indian/Alaskan Native (2/29, 7%) patients. No study included patients who identified as Native Hawaiian/Pacific Islander. The EHR was used to identify patients (25/29, 86%), drive the intervention (21/29, 72%), and monitor results and outcomes (7/29, 59%). Most often, EHR-driven approaches were used for health coaching interventions, disease management programs, clinical decision support (CDS) systems, and best practice alerts (BPAs). Regarding outcomes, out of 8 EHR-driven health coaching interventions, only 3 (38%) reported significant results. In contrast, all the included studies related to CDS and BPA applications reported some significant results with respect to improving hypertension management. CONCLUSIONS: This review identified several use cases for the integration of the EHR in supporting primary care interventions to strengthen hypertension management in racial and ethnic minoritized patients in the United States. Some clinical-based interventions implementing CDS and BPA applications showed promising results. However, more research is needed on community-based interventions, particularly those focusing on patients who are Asian American, American Indian/Alaskan Native, and Native Hawaiian/Pacific Islander. The developed taxonomy comprising “identifying patients,” “driving intervention,” and “monitoring results” to classify EHR-driven approaches can be a helpful tool to facilitate this. JMIR Publications 2023-09-15 /pmc/articles/PMC10541643/ /pubmed/37713256 http://dx.doi.org/10.2196/42409 Text en ©Dominik Ose, Emmanuel Adediran, Robert Owens, Elena Gardner, Matthew Mervis, Cindy Turner, Emily Carlson, Danielle Forbes, Caitlyn Lydia Jasumback, John Stuligross, Susan Pohl, Bernadette Kiraly. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 15.09.2023. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Review Ose, Dominik Adediran, Emmanuel Owens, Robert Gardner, Elena Mervis, Matthew Turner, Cindy Carlson, Emily Forbes, Danielle Jasumback, Caitlyn Lydia Stuligross, John Pohl, Susan Kiraly, Bernadette Electronic Health Record–Driven Approaches in Primary Care to Strengthen Hypertension Management Among Racial and Ethnic Minoritized Groups in the United States: Systematic Review |
title | Electronic Health Record–Driven Approaches in Primary Care to Strengthen Hypertension Management Among Racial and Ethnic Minoritized Groups in the United States: Systematic Review |
title_full | Electronic Health Record–Driven Approaches in Primary Care to Strengthen Hypertension Management Among Racial and Ethnic Minoritized Groups in the United States: Systematic Review |
title_fullStr | Electronic Health Record–Driven Approaches in Primary Care to Strengthen Hypertension Management Among Racial and Ethnic Minoritized Groups in the United States: Systematic Review |
title_full_unstemmed | Electronic Health Record–Driven Approaches in Primary Care to Strengthen Hypertension Management Among Racial and Ethnic Minoritized Groups in the United States: Systematic Review |
title_short | Electronic Health Record–Driven Approaches in Primary Care to Strengthen Hypertension Management Among Racial and Ethnic Minoritized Groups in the United States: Systematic Review |
title_sort | electronic health record–driven approaches in primary care to strengthen hypertension management among racial and ethnic minoritized groups in the united states: systematic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10541643/ https://www.ncbi.nlm.nih.gov/pubmed/37713256 http://dx.doi.org/10.2196/42409 |
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