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Real-World Evaluation of an Automated Algorithm to Detect Patients With Potentially Undiagnosed Hypertension Among
Mika D Thompson1, Yan Yan Wu1, Blythe Nett2
1Office of Public Health Studies University of Hawai'i at Mānoa Honolulu HI.
Journal of the American Heart Association
|December 12, 2023
Summary
An algorithm identified patients with potentially undiagnosed hypertension in Hawai'i. Factors like age, lack of diabetes, and timing influenced detection, with the COVID-19 pandemic impacting results.
Area of Science:
- Health Informatics
- Cardiovascular Health
- Public Health
Background:
- Real-world evaluation of an algorithm for detecting undiagnosed hypertension in routine care patients.
- Study conducted in a large health system in Hawai'i.
- Investigated patient, clinical, and health system factors influencing detection, and the impact of the COVID-19 pandemic.
Purpose of the Study:
- Quantify patients with potentially undiagnosed hypertension.
- Summarize associated individual, clinical, and health system factors.
- Examine the effect of the COVID-19 pandemic on hypertension detection rates.
Main Methods:
- Analysis of electronic health records from 6 clinics (2018-2021).
- Comparison of patients flagged for undiagnosed hypertension against diagnosed and general patient populations.
- Modified Poisson regression used to calculate risk ratios for associated factors.
Main Results:
- Out of 13,364 eligible patients, 52.6% had diagnosed hypertension, 2.7% were flagged as potentially undiagnosed, and 44.6% had no hypertension evidence.
- Higher risk of undiagnosed hypertension associated with ages 40-84, lack of diabetes diagnosis, specific clinic sites, Medicaid beneficiary status, and post-COVID-19 Stay-At-Home Order readings.
- The COVID-19 pandemic influenced the detection of undiagnosed hypertension.
Conclusions:
- A clinical algorithm in EHRs can identify patients needing follow-up for hypertension status.
- Key factors contributing to undiagnosed hypertension include patient demographics, clinical status, health system variables, and timing of care.
- Findings highlight the need for targeted interventions to improve hypertension diagnosis and management in routine care settings.
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