Kottke Thomas E, Horst Sarah
HealthPartners, Minneapolis, MN.
ICSI Institute for Clinical Systems Improvement, Minneapolis, MN.
Perm J. 2019;23. doi: 10.7812/TPP/18-289. Epub 2019 Jun 14.
The decline in cardiovascular disease mortality is stalling, and Million Hearts, a nationwide cardiovascular risk factor control campaign, is only halfway to its goal. In this commentary we identify 3 barriers beyond public reporting of performance that are hard stops for many Medical Groups that are participating in the Million Hearts initiative: 1) the inability of many physicians to access and visualize their patient panel electronic medical record data for patient and quality management, 2) a lack of compensation for the cost of team-based primary care, and 3) external support for single-condition registries rather than a single registry that contains the information that is necessary to manage all conditions of interest. These barriers have been overcome by high-performing Medical Groups and, if their innovations are adopted as standard practice by the US health care community, we believe that the Million Hearts goal can be achieved.
心血管疾病死亡率的下降趋势正在停滞，而“百万心脏”（一项全国性的心血管危险因素控制运动）仅完成了其目标的一半。在这篇评论中，我们指出了除公开报告绩效之外的三个障碍，这些障碍对许多参与“百万心脏”倡议的医疗集团来说是难以逾越的障碍：1）许多医生无法访问和查看其患者群体的电子病历数据以进行患者管理和质量管理；2）缺乏对基于团队的初级保健成本的补偿；3）对单一疾病登记处的外部支持，而不是一个包含管理所有相关疾病所需信息的单一登记处。这些障碍已被表现出色的医疗集团克服，如果美国医疗保健界将它们的创新做法作为标准做法采用，我们相信“百万心脏”的目标是可以实现的。
