Almost half of all adults in the U.S. have high blood pressure, putting them at risk for heart disease—the leading cause of death in the country.
Of those adults with hypertension, only one in four has their blood pressure under control.
Leaders at Henry Ford Health saw similar statistics in their Detroit community. There are also significant gaps in the rate of hypertension control for Black adults, and specifically for Black men between the 35 and 64 years old.
Henry Ford Health connected with about 1,000 Black men in the Detroit area who had high BP and engaged with more than one-third of them. Of that group, almost half got their BP under control within six months.
"A lot of that success was due to the fact that we were improving medication adherence, we were giving them more support in their lifestyle changes, and we were helping them navigate any barriers that they might have faced in getting connected with the services," said Denise White Perkins, MD, PhD, chair of the family medicine department at Henry Ford Health, which is a member of the AMA Health System Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Dr. White Perkins shared how Henry Ford Health made such a positive impact for Black male patients with hypertension in a recent episode of “AMA Update.”
Creating express BP clinics
The first step for Henry Ford Health to make a difference was asking some difficult internal questions, Dr. White Perkins said.
“It's very important that you continually ask the question: Why might this particular segment of our patient population not be reaching the goal in the same way that others are?” she said. "And keep asking that question."
That is what the Henry Ford Health team did.
What they found is that many Black men needed to take time off work or from caregiving to attend a medical appointment. Others had to navigate transportation concerns.
“We wanted to really demonstrate that we valued their time and the effort that it took to get there," Dr. White Perkins said. “We did that by framing it as a VIP experience.”
Henry Ford Health promised appointments would take less than 15 minutes. The men were met at the front desk when they arrived and escorted by a pharmacist or nurse who would take care of them right away.
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“It's really about engagement and outreach and meeting the men where they are," Dr. White Perkins said. “We also recognized that the most essential thing we needed for that visit was a blood pressure reading. We could potentially call them later to provide education or give advice on medication changes.”
Target: BP™️, a national initiative co-led by the AMA and American Heart Association, leverages the AMA MAP™ Hypertension program to help care teams organize their approach to providing evidence-based care and helps health care organizations improve and sustain BP control with professional education, practice tools and resources. Annually, Target: BP recognizes health care organizations by awarding those who have commitment to improvement, adopted evidence-based BP activities, and achieved BP-control rates of 70% or greater among the patients they serve.
Using telehealth to reduce travel
The COVID-19 public health emergency demonstrated the value of telehealth, and Henry Ford Health leverages the modality with its Express Blood Pressure Clinics. Once patients make that initial appointment for their BP reading, they are able to conduct follow-up check-ins via telehealth.
During the initial visit, Henry Ford Health team members will demonstrate how to use a BP monitor so that the patients can use it on their own at home.
“We offer virtual care as a means by which our patients can get the education and counseling and medication titration," Dr. White Perkins said. "After we're assured that they know how to use the monitor, that they can access the virtual visit, they have the technology and the capability, then we can do much of the care through that virtual format if that's what they choose.”
The Express Blood Pressure Clinics’ results are encouraging so far, but Dr. White Perkins and her colleagues are always looking for ways to make an even greater impact.
“We used a data-driven, team-based approach to dig deeper and try to understand what we can do differently as a health system or as a team to improve care for these patients,” she said. "We're continuing to ask those questions as we try to further optimize this program."
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