Featured Research

from universities, journals, and other organizations

EHR algorithms developed to identify undiagnosed hypertension

Date:
July 16, 2014
Source:
Northwestern Memorial Hospital
Summary:
Reviewing electronic health records using algorithms can successfully identify patients with previously undiagnosed hypertension, or high blood pressure, with a high rate of accuracy, researchers say. hypertension affects one in three adults in America and is referred to as the "silent killer" because it rarely exhibits any warning signs, causing many to never know they had it. Because of the nature of this serious condition, hypertension is associated with more than 50 billion of dollars in costs related to medical care and lost productivity in America alone.

A new study authored by Northwestern Medicineฎ researchers found that reviewing electronic health records (EHRs) using algorithms can successfully identify patients with previously undiagnosed hypertension, or high blood pressure, with a high rate of accuracy. Of the 1,033 patients that were identified with the EHR algorithms and evaluated, 361 were formally diagnosed with the hypertension and 290 others were diagnosed with related blood pressure conditions such as prehypertension, white-coat hypertension or elevated blood pressure. The study, "A Technology-Based Quality Innovation to Identify Undiagnosed Hypertension Among Active Primary Care Patients," was published in the 2014 July/August issue of the Annals of Family Medicine.

According to the Centers for Disease Control and Prevention (CDC), hypertension affects one in three adults in America and is referred to as the "silent killer" because it rarely exhibits any warning signs, causing many to never know they had it. Because of the nature of this serious condition, hypertension is associated with more than 50 billion of dollars in costs related to medical care and lost productivity in America alone.

"Hypertension is easy to miss if someone is seeing multiple physicians," said the study's co-author David W. Baker, MD, MPH, chief of internal medicine and geriatrics at Northwestern Memorial Hospital and Northwestern University Feinberg School of Medicine. "A patient may see one doctor who thinks the blood pressure is due to the patient not feeling well that day and then see another doctor for a different problem who thinks the blood pressure is high because the patient was hurrying to make the appointment. No one puts all of these readings together and realizes a person's blood pressure is always elevated."

In the first part of the study, patients were identified as being at risk for undiagnosed hypertension using the three EHR algorithms and were invited to complete an automated office blood pressure (AOBP) test. AOBP testing was designed to eliminate falsely elevated blood pressure results associated with patients being in the presence of a health care provider, a condition known as the white coat effect. In the study, this blood pressure test was started by a medical assistant, who then left the patient alone in their examination room while the testing device obtained six blood pressures readings at one minute intervals. To best eliminate the white coat effect, the first reading was automatically thrown out and the remaining five were then averaged together to provide a single blood pressure reading that is much more accurate and representative of a patient's true blood pressure than a single manual office blood pressure test.

In the second part of the study, additional patients at risk for unidentified hypertension were identified with the same three EHR algorithms, and were then observed over the course of two years. These patients were contacted by health care staff and asked to arrange a follow-up appointment. All of the primary care physicians that participated in the study also received monthly lists of their patients who remained at risk for having hypertension according to the algorithms. Patients remained on the physicians' lists until an AOBP evaluation was completed or a diagnosis was entered into the chart that indicated the patient's at-risk status had been resolved.

"With this study, we created a surveillance system that notifies the medical staff and the primary care physician anytime a patient who is at risk arrives in the office," said principal investigator Michael K. Rakotz, MD, a family medicine physician at Northwestern Medicine Evanston. "Once these patients are identified we proceed with an AOBP to more accurately measure their blood pressure and make a diagnosis. This surveillance system never stops running, so any patient that meets the EHR algorithm criteria for possible hypertension will automatically be flagged. In doing so we hope to put an end to undiagnosed hypertension."

The study's authors conclude that in addition to using algorithms to screen EHR data for patients at risk for undiagnosed hypertension, this method may also be applicable to other commonly undiagnosed chronic diseases.


Story Source:

The above story is based on materials provided by Northwestern Memorial Hospital. Note: Materials may be edited for content and length.


Journal Reference:

  1. M. K. Rakotz, B. G. Ewigman, M. Sarav, R. E. Ross, A. Robicsek, C. W. Konchak, T. F. Gavagan, D. W. Baker, D. J. Hyman, K. P. Anderson, C. M. Masi. A Technology-Based Quality Innovation to Identify Undiagnosed Hypertension Among Active Primary Care Patients. The Annals of Family Medicine, 2014; 12 (4): 352 DOI: 10.1370/afm.1665

Cite This Page:

Northwestern Memorial Hospital. "EHR algorithms developed to identify undiagnosed hypertension." ScienceDaily. ScienceDaily, 16 July 2014. <www.sciencedaily.com/releases/2014/07/140716123456.htm>.
Northwestern Memorial Hospital. (2014, July 16). EHR algorithms developed to identify undiagnosed hypertension. ScienceDaily. Retrieved October 21, 2014 from www.sciencedaily.com/releases/2014/07/140716123456.htm
Northwestern Memorial Hospital. "EHR algorithms developed to identify undiagnosed hypertension." ScienceDaily. www.sciencedaily.com/releases/2014/07/140716123456.htm (accessed October 21, 2014).

Share This



More Health & Medicine News

Tuesday, October 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

CDC Revamps Ebola Guidelines After Criticism

CDC Revamps Ebola Guidelines After Criticism

Newsy (Oct. 21, 2014) — The Centers for Disease Control and Prevention have issued new protocols for healthcare workers interacting with Ebola patients. Video provided by Newsy
Powered by NewsLook.com
WHO: Ebola Vaccine Trials to Start a in January

WHO: Ebola Vaccine Trials to Start a in January

AP (Oct. 21, 2014) — Tens of thousands of doses of experimental Ebola vaccines could be available for "real-world" testing in West Africa as soon as January as long as they are deemed safe in soon to start trials, the World Health Organization said Tuesday. (Oct. 21) Video provided by AP
Powered by NewsLook.com
First-Of-Its-Kind Treatment Gives Man Ability To Walk Again

First-Of-Its-Kind Treatment Gives Man Ability To Walk Again

Newsy (Oct. 21, 2014) — A medical team has for the first time given a man the ability to walk again after transplanting cells from his brain onto his severed spinal cord. Video provided by Newsy
Powered by NewsLook.com
CDC Issues New Ebola Guidelines for Health Workers

CDC Issues New Ebola Guidelines for Health Workers

Reuters - US Online Video (Oct. 21, 2014) — The U.S. Centers for Disease Control and Prevention has set up new guidelines for health workers taking care of patients infected with Ebola. Linda So reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins