Heart Disease and Stroke

PSR NATIONAL SUMMARY

Icon depicting a heart with a heart monitor spike running thru itThe Prevention Status Reports highlight—for all 50 states and the District of Columbia—the status of public health policies and practices designed to address 10 important public health problems and concerns. This report focuses on one policy and one practice recommended by the Community Preventive Services Task Force, the US Public Health Service, Institute of Medicine, and the American College of Clinical Pharmacy because scientific studies support their effectiveness in managing heart disease and stroke risks (1–4):

  • Implementing meaningful use of certified electronic health records
  • Establishing state collaborative drug therapy management (CDTM) policies that authorize pharmacists to provide certain patient services

Other strategies for reducing heart disease and stroke that are supported by scientific evidence and practice include promoting team-based care, implementing clinical decision-support systems, using interventions that engage community health workers, reducing out-of-pocket costs for cardiovascular disease preventive services, and reducing sodium consumption at the community level (5,6).

Meaningful use of electronic health records

The percentage of office-based physicians demonstrating meaningful use of certified electronic health record (EHR) technology, as defined by the Centers for Medicare & Medicaid Services EHR Incentive Program’s meaningful use criteria (7).

RatingPercentage of office-based physicians in the state who demonstrated meaningful use
Green≥62.0%
Yellow53.0%–61.9%
Red<53.0%


How These Ratings Were Determined
These ratings reflect meaningful use of certified EHRs in each state as measured by the Centers for Medicare & Medicaid Services (8). Certified EHR technology must include clinical decision supports, such as alerts for elevated blood pressure and cholesterol levels based on laboratory results, to support guidelines-based clinical decision making (9).

State pharmacist collaborative drug therapy management policy

A state legislative, regulatory, or other written administrative policy that authorizes qualified pharmacists working within the context of a collaborative practice agreement or defined protocol to perform patient assessments; order drug therapy-related laboratory tests; administer drugs; and/or select, initiate, monitor, continue, and adjust drug regimens (1–4).

RatingState CDTM policy
GreenAuthorized pharmacists to collaborate or provide patient services under protocol for all health conditions
YellowAuthorized pharmacists to collaborate or provide patient services under protocol but did not cover chronic diseases, OR collaboration was limited to specified hospital, medical, or clinical practice settings
RedNo policy existed


How These Ratings Were Determined
These ratings reflect the status of state CDTM policies as reviewed by CDC policy analysts (10). CDTM policies were rated on the extent to which pharmacists were able to enter into collaborative practice agreements that included all health conditions and all healthcare settings.

References

  1. Community Preventive Services Task Force. Cardiovascular disease prevention and control: team-based care to improve blood pressure controlExternal Link. In: Guide to Community Preventive Services. Updated Apr 2012.
  2. Giberson S, Yoder S, Lee MP. Improving Patient and Health System Outcomes Through Advanced Pharmacy Practice. A Report to the U.S. Surgeon General 2011External Link. Rockville, MD: US Public Health Service; 2011.
  3. Institute of Medicine. Primary Care and Public Health: Exploring Integration to Improve Population HealthExternal Link. Washington, DC: National Academies Press; 2012.
  4. American College of Clinical Pharmacy. ACCP position statement: collaborative drug therapy management by pharmacists—2003External Link. Pharmacotherapy 2003;23(9)1210–25.
  5. Frieden TR, Berwick DM. The “Million Hearts” initiative—preventing heart attacks and strokesExternal Link. New England Journal of Medicine 2011;365(13):e27.
  6. Community Preventive Services Task Force. Cardiovascular disease prevention and controlExternal Link. In: Guide to Community Preventive Services. Updated Nov 24, 2015.
  7. US Department of Health and Human Services. EHR Incentives & Certification: How to Attain Meaningful UseExternal Link. Accessed Jun 10, 2015.
  8. US Department of Health and Human Services. EHR Incentives & Certification: Meaningful use Definition & ObjectivesExternal Link. Accessed Sep 25, 2015.
  9. US Department of Health and Human Services. ONC Health IT Certification Program.External Link. Standards and Certification Criteria. Accessed Jun 11, 2015.
  10. CDC. Chronic Disease State Policy Tracking System. Accessed Jun 10, 2015.


**State count includes District of Columbia.

Page last reviewed: 4/10/2019