A Technology-Based Quality Innovation to Identify Undiagnosed Hypertension Among Active Primary Care Patients

In Brief

A Technology-Based Quality Innovation to Identify Undiagnosed Hypertension Among Active Primary Care Patients

Michael K. Rakotz , and colleagues

Background Hypertension (high blood pressure) can be difficult to diagnose. This study describes the development and evaluation of a technology-based strategy to screen for undiagnosed hypertension and the implementation of a continuous quality improvement process to improve the accuracy of hypertension diagnosis.

What This Study Found 1,432 patients at risk for undiagnosed hypertension were invited to complete an automated office blood pressure protocol to obtain multiple blood pressure measurements. A quality improvement process was then implemented, including regular physician feedback and office-based computer alerts to further evaluate the 1,033 at-risk patients not screened in phase one. The initiative successfully identified patients at risk for undiagnosed hypertension and classified most patients based on their automated office blood pressure reading. Specifically, this process reduced the rate of being at risk for undiagnosed hypertension over a 30-month follow-up period by more than 72%. By the end of the follow-up period, 293 patients (28%) had not yet been classified and remained at risk for undiagnosed hypertension.

Implications

• The authors suggest that these strategies not only have the potential to eliminate undiagnosed hypertension, they also may be applicable to other common undiagnosed chronic diseases. In addition, similar methods can be adapted to inform clinicians and patients on blood pressure control after the diagnosis of hypertension.