Abstract P354: Leveraging Electronic Health Records For Quality Improvement Among Patients With Markedly Elevated Blood Pressure

Abstract

Introduction: Electronic health records (EHR) can improve quality of care for patients with markedly elevated blood pressure (BP). This study aimed to develop EHR-based computable algorithms to identify barriers to BP control and enhance triage and patient management. Methods: We conducted a retrospective analysis using EHR data from Yale New Haven Health System (YNHHS) employees and their dependents. Patients with markedly elevated BP had ≥2 outpatient BP readings ≥160/100 mmHg within a 180-day period. We assessed 3-month follow-up visits after BP elevation, along with the proportions of patients prescribed antihypertensives, filled prescriptions, and self-reported adherence using EHR data sources. Results: The study included 46,361 adult patients, with a mean age of 45.7 (14.5) years; 65% were female, 59% were White, and 17% were Black. Among them, 1,437 (3.3%) had markedly elevated BP, and 880 (1.9%) had consecutive markedly elevated BP readings. Among patients with markedly elevated BP, 626 (43.6%) had follow-up visits with relevant specialties within 3 months after the BP elevation. Moreover, 970 (67.5%) patients had antihypertensive prescriptions, of whom 927 (95.6%) filled their prescriptions, and among those who filled prescriptions, 806 (87.2%) reported taking the medications. Black patients were more likely to receive antihypertensive prescriptions but less likely to fill them or report taking medications (Figure). Conclusion: This study demonstrates the potential of EHR data and computable algorithms to enhance patient triage, interventions, and resource allocation for effective BP reduction among YNHHS employees.