Step by Step, Improving Heart Health in America

By David Meyers MD, AHRQ’s Chief Physician
Twitter: @AHRQNews

Despite continuing progress, the imperative to improve the nation’s heart health remains urgent. Heart disease kills more than 600,000 Americans each year. More than 140,000 die following stroke. Tragically, many of these deaths are premature.

What’s clear is that a multi-faceted approach is required. Further significant gains in heart health will only occur if we do better at keeping people healthy, monitoring those at risk, and providing the right care for those whose hearts are ailing.

The commemoration of another Heart Health Month has prompted me to consider AHRQ’s contributions to improve heart health. I’m pleased by our support of HHS’ Million Hearts®, a coordinated national effort to improve heart health with which our EvidenceNOW initiative is closely aligned. I’m also excited about a new initiative in 2019—a 3-year project to increase the use of cardiac rehabilitation.

First, some highlights from 2018.

AHRQ’s EvidenceNOW initiative continued its support of regional cooperatives that helped more than 1,500 small- and medium-sized primary care practices integrate evidence-based approaches to improve heart health. As part of EvidenceNOW, evaluations were conducted of practices’ use of health information technology (IT). The results, summarized in a recent infographic, were insightful. Among the findings: electronic health records (EHRs) were used by 93 percent of practices. Many of the EHRs, however, were not designed to support quality improvement or research. And only about 6 in 10 practices shared patient health data electronically with other providers or organizations.

In addition, the EvidenceNOW project developed Tools for Change, a curated, online collection of more than 100 resources to help primary care practices provide evidence-based care. The resource allows practice facilitators to search for tools that address needs such as finding new evidence, optimizing health IT, and engaging with patients and families.

In the coming weeks, AHRQ will broaden its efforts to improve heart health with a new project aimed at advancing another important strategy: increasing the use of cardiac rehabilitation among patients who have experienced a coronary event.

Cardiac rehabilitation is a medically supervised program that involves education, exercise training, and psychological support, with each facet designed to help cardiac patients return to an active lifestyle.

Each year, about 965,000 Americans experience a coronary event. Only about 20 percent of eligible patients, however, participate in cardiac rehabilitation. This low level of participation represents an enormous missed opportunity: some estimates suggest that increasing cardiac rehabilitation participation to 70 percent would save nearly 25,000 lives and prevent about 180,000 hospitalizations a year.

AHRQ’s new project will tackle the problem in several ways, including partnering with and training of hospitals and health systems to increase rehabilitation referrals, enrollment, and retention. These efforts will apply strategies in the new Million Hearts®/AACVPR Cardiac Rehabilitation Change Package [PDF], an action plan developed by the Centers for Disease Control and Prevention and the American Association of Cardiovascular and Pulmonary Rehabilitation. AHRQ’s new initiative will also develop an online platform to raise awareness about the benefits of cardiac rehabilitation and provide new and existing resources that promote its use.

We’ll keep you posted on the progress of this exciting new initiative. I’m confident it will emerge as an important part of the nationwide effort to reduce the number of Americans whose lives are limited and cut short due to heart disease.

This article was originally published on AHRQ Views Blog and is republished here with permission.