May 29, 2015
The University of North Carolina at Chapel Hill and a cooperative team of health-care and quality improvement experts have been awarded a $15M federal grant from the Agency for Healthcare Research and Quality (AHRQ). The funding will help primary-care practices use the latest evidence to improve the heart health of millions of Americans.
Sam Cykert, MD, professor of medicine in UNC’s School of Medicine and director of UNC’s Program on Health and Clinical Informatics, is principal investigator for the project, and Bryan Weiner, PhD, professor of health policy and management at UNC’s Gillings School of Global Public Health and deputy director for research at UNC’s Cecil G. Sheps Center for Health Services Research, is co-investigator.
The UNC effort, called “Heart Health Now! Advancing Heart Health in N.C. Primary Care,” is one of seven grants awarded as part of the AHRQ initiative, EvidenceNOW – Advancing Heart Health in Primary Care. That initiative supports the broad U.S. Department of Health and Human Services (HHS) program for Better Care, Smarter Spending and Healthier People and is aligned with the Department’s Million Hearts® national initiative to prevent heart attacks and strokes.
“Heart Health Now!” is based at the Cecil B. Sheps Center for Health Services Research, in partnership with the N.C. Area Health Education Center (AHEC) program’s Practice Support Services, the UNC School of Medicine, and Community Care of North Carolina (CCNC) and its family of Informatics Services. AHEC and CCNC already have built a standard of success in these areas.
“The goal of the EvidenceNOW initiative is to give primary care practices the support they need to help patients live healthier and longer,” said HHS Secretary Sylvia M. Burwell. “By targeting smaller practices, we have a unique opportunity to reduce cardiovascular risk factors for hundreds of thousands of patients and learn what kind of support results in better patient outcomes.”
Heart disease is the leading cause of death for men and women in the United States. In North Carolina, the latest data show an annual cardiovascular death rate of 263 per 100,000, a higher death rate than by any other cause and amounting to almost one-third of deaths in the state.
To prevent heart attacks, it is critical that health-care professionals work with patients to adopt the ABCs of cardiovascular prevention — Aspirin use by high-risk individuals, Blood pressure control, Cholesterol management, and Smoking cessation. New evidence about how best to deliver the ABCs is evolving continually. The initiative’s goal is to ensure that primary-care practices have evidence they need and use it to help patients live healthier and longer.
As part of the EvidenceNOW initiative, “Heart Health Now!” is composed of public and private partnerships and multidisciplinary teams of experts that will recruit and engage 250-300 small, independent primary-care practices and provide quality improvement services typically not available to them because of their size. These services include onsite practice facilitation and coaching, expert consultation, shared learning collaboratives and electronic health-record support.
“I’ve cared for many people who suffered the debilitating effects of a heart attack or stroke way too early,” Cykert said. “Because of the lack of sophisticated information systems and processes that could quickly identify risk and prioritize new evidence for care, many of these folks missed opportunities that could have prevented the paralysis, shortness of breath and death that often resulted from premature disease. By partnering with North Carolina practices to build in the needed supports, we have the potential to prevent thousands of heart attacks, strokes and deaths within a few short years.”
Weiner agreed that program efforts would improve the health and quality of life of many North Carolinians.
“We also will advance the science and practice of implementation,” he said. “In particular, we will learn how to effectively and efficiently provide implementation support to primary care practices with varying capabilities, resources and readiness.”
“Heart Health Now!” will conduct an internal evaluation, but AHRQ also awarded a grant to the Oregon Health and Science University (OHSU) to conduct an independent national evaluation of the overall EvidenceNOW initiative. The team will study the impact of the EvidenceNOW interventions on practice improvement and the delivery of cardiovascular care and determine which practice supports and quality improvement strategies are most effective in improving the implementation of new evidence.
UNC’s grant will run for three years and the evaluation grant for four years. Together, the grants represent one of the largest research investments to date by AHRQ.
EvidenceNOW supports AHRQ’s overall mission to ensure that evidence is understood and used. Funding for this initiative comes from the Patient-Centered Outcomes Research Trust Fund created by the Affordable Care Act and supports AHRQ’s mandate to disseminate and implement patient-centered outcomes research findings so that new findings are integrated into the delivery of health care. More information about EvidenceNOW, including details on each of the grantees and cooperatives, is available online.