Heart disease, stroke and diabetes are three of the leading causes of death in Hawaiʻi. Many people do not know that they have a chronic condition, even those with regular healthcare.
To improve patient health and possibly prevent deaths from chronic conditions, a team of state partners and researchers with the University of Hawaiʻi at 惭ā苍辞补 collaborated to improve the assessment of undiagnosed conditions in patients through new algorithms and analysis that could help hundreds of people in the state.
Our work highlights the potential of a relatively simple health information technology intervention
—Catherine Pirkle
Among the important findings: 53% of adults receiving regular care at six primary clinics in The Queen’s Health System (QHS) had diagnosed hypertension and only 3% of adults exhibited high blood pressure readings without a formal diagnosis, showcasing the clinics’ effectiveness in diagnosing hypertension cases. Additionally, Medicaid beneficiaries with clinical evidence of hypertension were less likely to receive a diagnosis compared to those covered by other insurance types. Also, the COVID-19 pandemic led to underdiagnosis of hypertension.
Supported by two Centers for Disease Control and Prevention grants, the initiative was a collaboration with the Hawaiʻi State Department of Health (DOH), The Queen’s Clinically Integrated Physician Network (QCIPN) and The QHS. The initiative was a part of national efforts to increase detection of chronic conditions and improve patient quality of care.
“This research is an excellent example of collaboration between academic, governmental and healthcare partners committed to improving the population’s health. Our work highlights the potential of a relatively simple health information technology intervention,” said Catherine M. Pirkle, associate professor and corresponding author.
Algorithms developed to assess undiagnosed hypertension
DOH developed automated algorithms, which were then implemented by The QHS in the electronic data warehouse of six primary care clinics. UH faculty and students conducted evaluations, assessing the effectiveness of the algorithms in identifying potentially undiagnosed conditions, while also exploring factors placing individuals at higher risk of not getting an appropriate diagnosis for hypertension.
“Understanding these factors can help to inform new clinical workflows to improve hypertension diagnosis, an important step to reducing the prevalence of hypertension in Hawaiʻi,” said lead-author and epidemiology PhD student, Mika D. Thompson.
Results of the hypertension algorithm evaluation, presented at the American Public Health Association annual conference and published in the , revealed that 53% of adults at QCIPN clinics had diagnosed hypertension, which is higher than the 26% of adults who reported having hypertension in a .
Other co-authors of the study include Blythe Nett, Yanyan Wu, Tetine L. Sentell, Meghan D. McGurk, Lance K. Ching, Hermina Taylor and Tiffany Lemmen.