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ABCs of Million Hearts in Missouri by Dr. Janet Wright
Goal: Prevent 1 million heart attacks
       and strokes in 5 years
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ABCs of Million Hearts in Missouri by Dr. Janet Wright
Focus on
ABCS

Health
information
technology

              TRANS
               FAT
Total = $6.86




                                                Total = $5.26
                                Total = $4.64


                Total = $3.39




Total = $1.58
Percent of adults
WA

                                                                                                                            ME


                                                                                                                  VT
        OR                                                                                                             NH
                                                                                                                       MA
                                                                                                            NY
                                                                                                                      CT     RI
                                                                                    MI

                      .                                                                                          NJ

                                                                          IL                           MD
                                                                                             OH                  DE


        CA
                                                                                        KY


                                                                                   TN

                                        NM                                                        SC



                                                                           MS

                                                   TX




                                   HI




    Enacted or passed trans fat regulation in food service establishments (FSEs)
    Trans fat regulation in FSEs introduced, defeated, or stalled
8
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ABCs of Million Hearts in Missouri by Dr. Janet Wright
ABCs of Million Hearts in Missouri by Dr. Janet Wright
ABCs of Million Hearts in Missouri by Dr. Janet Wright
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PQRS CV Prevention          HRSA
        MH CQMs        PQRS       MU                            ACOs              NQF
                                            Measures Group             UDS



Aspirin Use          PQRS #204   S1 opt                                         NQF #0068



BP Screening



BP Control           PQRS #236   S1 opt,                                Yes     NQF #0018



Chol Control – Pop



Chol Cont – DM        PQRS #2    S1 opt                                         NQF #0064



Chol Cont – IVD      PQRS #241   S1 opt                                         NQF #0075


                                                                         Yes
Smoking Cessation    PQRS #226   S1 core                                        NQF #0028
                                                                       (2011)
PQRS CV Prevention
        MH CQMs        PQRS           MU                               ACOs   HRSA UDS       NQF
                                                   Measures Group


                                     S1 opt,
Aspirin Use          PQRS #204                           Yes           Yes    Yes (2012)   NQF #0068
                                 S2 core (prop)


BP Screening         PQRS #317                           Yes           Yes


                                     S1 opt,
BP Control           PQRS #236                           Yes           Yes       Yes       NQF #0018
                                 S2 core (prop)


Chol Control – Pop   PQRS #316   S2 core (prop)                                              TBD*


                                    S1 opt,
Chol Cont – DM        PQRS #2                            Yes           Yes                 NQF #0064
                                 S2 opt (prop)


                                    S1 opt,
Chol Cont – IVD      PQRS #241                           Yes           Yes                 NQF #0075
                                 S2 opt (prop)


                                    S1 core,
Smoking Cessation    PQRS #226                           Yes           Yes    Yes (2011)   NQF #0028
                                 S2 core (prop)
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ABCs of Million Hearts in Missouri by Dr. Janet Wright
SMDs                                                                 SHOs




State Medical,      Schools of      Patient & Science
  Pharmacy,          Medicine       Advocacy Groups     Employers &   Corporate
 Nursing, etc    Pharmacy,Nursing,   (WomenHeart,        Insurers     Partners
 Associations    Public Health, etc       AHA)
Getting to Goal

                                                                                           Clinical
           Intervention                                    Baseline           Target
                                                                                            target

Aspirin for those at high risk                                  47%            65%          70%

Blood pressure control                                          46%            65%          70%

Cholesterol management                                          33%            65%          70%

Smoking cessation                                               23%            65%          70%


Sodium reduction                                          ~ 3.5 g/day      20% reduction

Trans fat reduction                                   ~ 1% of calories     50% reduction



  Unpublished estimates from Prevention Impacts Simulation Model (PRISM)
Whelton, PK, et al. JAMA 2002;288:1882
Stamler R, et al, Hypertension 1991:17:I-16
           ’
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
       “           ”









    Adding web-based pharmacist care
    to home blood pressure monitoring
         increases control by >50%
     Green BB, et al. JAMA 2008;299:2857-67


    
    
    
    


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ABCs of Million Hearts in Missouri by Dr. Janet Wright

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ABCs of Million Hearts in Missouri by Dr. Janet Wright

  • 2. Goal: Prevent 1 million heart attacks and strokes in 5 years
  • 3.       
  • 6. Total = $6.86 Total = $5.26 Total = $4.64 Total = $3.39 Total = $1.58
  • 8. WA ME VT OR NH MA NY CT RI MI . NJ IL MD OH DE CA KY TN NM SC MS TX HI Enacted or passed trans fat regulation in food service establishments (FSEs) Trans fat regulation in FSEs introduced, defeated, or stalled 8
  • 13.    
  • 14. PQRS CV Prevention HRSA MH CQMs PQRS MU ACOs NQF Measures Group UDS Aspirin Use PQRS #204 S1 opt NQF #0068 BP Screening BP Control PQRS #236 S1 opt, Yes NQF #0018 Chol Control – Pop Chol Cont – DM PQRS #2 S1 opt NQF #0064 Chol Cont – IVD PQRS #241 S1 opt NQF #0075 Yes Smoking Cessation PQRS #226 S1 core NQF #0028 (2011)
  • 15. PQRS CV Prevention MH CQMs PQRS MU ACOs HRSA UDS NQF Measures Group S1 opt, Aspirin Use PQRS #204 Yes Yes Yes (2012) NQF #0068 S2 core (prop) BP Screening PQRS #317 Yes Yes S1 opt, BP Control PQRS #236 Yes Yes Yes NQF #0018 S2 core (prop) Chol Control – Pop PQRS #316 S2 core (prop) TBD* S1 opt, Chol Cont – DM PQRS #2 Yes Yes NQF #0064 S2 opt (prop) S1 opt, Chol Cont – IVD PQRS #241 Yes Yes NQF #0075 S2 opt (prop) S1 core, Smoking Cessation PQRS #226 Yes Yes Yes (2011) NQF #0028 S2 core (prop)
  • 16.    
  • 17.      
  • 19.     ’           ’            
  • 21. SMDs SHOs State Medical, Schools of Patient & Science Pharmacy, Medicine Advocacy Groups Employers & Corporate Nursing, etc Pharmacy,Nursing, (WomenHeart, Insurers Partners Associations Public Health, etc AHA)
  • 22. Getting to Goal Clinical Intervention Baseline Target target Aspirin for those at high risk 47% 65% 70% Blood pressure control 46% 65% 70% Cholesterol management 33% 65% 70% Smoking cessation 23% 65% 70% Sodium reduction ~ 3.5 g/day 20% reduction Trans fat reduction ~ 1% of calories 50% reduction Unpublished estimates from Prevention Impacts Simulation Model (PRISM)
  • 23. Whelton, PK, et al. JAMA 2002;288:1882 Stamler R, et al, Hypertension 1991:17:I-16
  • 24. ’  ’       “ ” 
  • 25.       Adding web-based pharmacist care to home blood pressure monitoring increases control by >50% Green BB, et al. JAMA 2008;299:2857-67
  • 26.         