QIO Aids in Improving Heart Health for Oklahoma’s Native Americans

The Oklahoma Foundation for Medical Quality (OFMQ), Oklahoma's QIO through July 2014*, worked with partners to reduce key heart disease risk factors among the state’s more than 300,000 Native Americans.  Heart disease is a leading cause of death for most ethnic groups in the U.S., and is second only to cancer for Asian Americans or Pacific Islanders and American Indians or Alaska Natives, according to the Centers for Disease Control and Prevention.

Through its Cardiac Learning and Action Network (LAN) initiative ─ a Centers for Medicare & Medicaid Services (CMS) project ─ and other outreach events, OFMQ and the Oklahoma City Area Inter-Tribal Health Board have helped spread the importance of heart health and the goals of the Million Hearts™ campaign to the Oklahoma Native American population. The Million Hearts™ campaign is a national public-private initiative of the Department of Health and Human Services that aims to prevent 1 million heart attacks and strokes by 2017.

As part of the Cardiac LAN efforts, OFMQ staff conducted support calls and site visits with Native American clinics to help them more meaningfully use electronic health records (EHRs) and standardize data collection on blood pressure, aspirin therapy, smoking cessation, and other cardiac-related measures. OFMQ also helped the clinics identify best practices and areas of improvement to promote continued improvement in these measures.

OFMQ gathered its baseline data for the LAN in June 2011, and its most recent re-measurement data was reported in December 2013. Overall, the clinics participating in the LAN, which represent 347 physicians and more than 50,000 cardiac patients, showed improvement on cardiovascular measures. LAN participants reduced LDL cholesterol by 5.8 percent, improved tobacco cessation counseling by 8.9 percent, and increased the appropriate use of aspirin therapy by 8.2 percent. The strongest performance within the LAN came from Oklahoma’s Choctaw Nation Health System, which includes nine clinics and 122 physicians serving more than 17,000 cardiac patients.  The Choctaw Nation showed 6.5 percent improvement for LDL cholesterol reduction, 10.3 percent improvement for tobacco cessation counseling, and 12.4 percent for increased appropriate use of aspirin therapy. 

*In spring of 2014, CMS determined to separate the consumer type protection activities - case review, beneficiary complaint and appeals - from the quality improvement work for the QIO program going forward.  As of August 1, Oklahoma is represented by two Quality Improvement Organizations. TMF Health Quality Institute has partnered with the Arkansas Foundation for Medical Care, Primaris in Missouri and the Quality Improvement Professional Research Organization, Inc. in Puerto Rico to form the TMF Quality Innovation Network Quality Improvement Organization (QIN-QIO) to provide quality improvement work throughout Arkansas, Missouri, Oklahoma, Puerto Rico and Texas. Beneficiary and family centered care services are now provided by KEPRO.