The Kaiser Permanente Northern California Hypertension Project 2001-2012: How an integrated care delivery system increased and maintained blood pressure control rates from 44% to 86% in 11 years

Abstract

Small studies have been published on the effect of hypertension programs on blood pressure (BP) control, but few studies have reported the efficacy of a large-scale hypertension programs. Kaiser Foundation Health Plan of Northern California is a not-for-profit integrated health care delivery system with a membership of over 2.3 million adult members. In 2001, the Kaiser Permanente Northern California Hypertension Project was developed as an evidence-based program to increase BP control for members with hypertension. We previously reported our experience from 2001 to 2009, and in this report we describe the results from 2009 to 2012. In 2001, the Kaiser Permanente Northern California Hypertension Project was established. A registry of patients with hypertension was created to identify at-risk patients. Physician level and Medical Center level metrics were established to measure performance over time. An evidence based clinical practice guideline was developed, disseminated, reviewed and updated every 2 years. Clinicians were systematically educated on the guidelines and updated on their individual and group hypertension control performance measurements. Infrastructure was established including the creation of medical assistant BP checks and promotion of single pill combination medical therapy with angiotensin-converting enzyme inhibitor (ACEI) and hydrochlorothiazide (HCTZ). Medical centers that