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Leveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure

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 bloo...

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Autores principales: Lu, Yuan, Huang, Chenxi, Mahajan, Shiwani, Schulz, Wade L., Nasir, Khurram, Spatz, Erica S., Krumholz, Harlan M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428633/
https://www.ncbi.nlm.nih.gov/pubmed/32200730
http://dx.doi.org/10.1161/JAHA.119.015033
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author Lu, Yuan
Huang, Chenxi
Mahajan, Shiwani
Schulz, Wade L.
Nasir, Khurram
Spatz, Erica S.
Krumholz, Harlan M.
author_facet Lu, Yuan
Huang, Chenxi
Mahajan, Shiwani
Schulz, Wade L.
Nasir, Khurram
Spatz, Erica S.
Krumholz, Harlan M.
author_sort Lu, Yuan
collection PubMed
description 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.
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spelling pubmed-74286332020-08-17 Leveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure Lu, Yuan Huang, Chenxi Mahajan, Shiwani Schulz, Wade L. Nasir, Khurram Spatz, Erica S. Krumholz, Harlan M. J Am Heart Assoc Original Research 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. John Wiley and Sons Inc. 2020-03-23 /pmc/articles/PMC7428633/ /pubmed/32200730 http://dx.doi.org/10.1161/JAHA.119.015033 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Lu, Yuan
Huang, Chenxi
Mahajan, Shiwani
Schulz, Wade L.
Nasir, Khurram
Spatz, Erica S.
Krumholz, Harlan M.
Leveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure
title Leveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure
title_full Leveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure
title_fullStr Leveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure
title_full_unstemmed Leveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure
title_short Leveraging the Electronic Health Records for Population Health: A Case Study of Patients With Markedly Elevated Blood Pressure
title_sort leveraging the electronic health records for population health: a case study of patients with markedly elevated blood pressure
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428633/
https://www.ncbi.nlm.nih.gov/pubmed/32200730
http://dx.doi.org/10.1161/JAHA.119.015033
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