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Center for Clinical Translational Research

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Creating Best Practices in Managing Hypertension: Education and Health Information Technology

Billings Clinic Center for Clinical Translational Research has been invited to participate in a national collaborative sponsored by the American Medical Group Association and Daiichi Sankyo, Inc. This Learning Collaborative will focus on Best Practices in Managing Hypertension.


Hypertension (HTN) affects an estimated one-third of adults in the US. Uncontrolled, it carries significant vascular risk. Despite well-defined disease management guidelines published by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of HTN (JNC-7), only about one-third of persons treated for HTN have achieved adequate control. Since lowering high BP to normal levels has been shown to reduce risk of complications, this situation is not unacceptable. Barriers to successful management result from a complex interaction among provider, patient, health care system, and community influences. Success with overcoming these barriers has been limited. To treat HTN effectively, a primary care office must have an educated care team, motivated patients, and the appropriate health information system (HIT) to drive patient quality and safety. HIT solutions seem the logical choice for disease management, but evidence supporting its effectiveness is sparse. The Center for Clinical Translational Research in collaboration with Internal Medicine proposes a program to improve the use of ‘Best Practices in Managing Hypertension’ among clinicians at Billings Clinic.


Clinic – targeted:

  1. Create clinic-wide consensus on best practice guidelines (JNC7)
    • Create consensus among physicians and NPPs
      • Educate physicians
      • Educate nurses
      • Increase adherence to best practices
      • Improve BP techniques among clinic staff
      • Increase patient education about hypertension
      • Increase the proportion of patients with blood pressure levels considered ‘in control’ per established guidelines

Project components

  1. Focus groups
    • Identify physician and nurse champions, create protocols identifying when and how to take a correct BP, change current office flow processes
  2. Information technology
    • Develop HTN Report Card
    • Develop HTN e-registry
  3. Patients
    • A “Patient empowerment” component/tool will be included to encourage patients to report changes in their blood pressure readings
  4. Data Collection
    • Pre/Post knowledge and attitude survey
    • Behavior will be measured by chart review (increased number of patients considered ‘in control’)


  1. Physician led Hypertension management program
  2. increase the proportion of patients with blood pressure levels considered ‘in control’
  3. Implement a HTN patient report card
  4. Develop and implement a HTN e-registry

We believe that adherence to best practice guidelines for the management of HTN will greatly improve the quality of care our patients receive and result in significant improvements in patient health, particularly among those suffering from medically complex conditions.

Learning Collaborative Members:

  • Billings Clinic, Billings, MT
  • Edmonds Family Medicine Clinic, Edmonds, WA
  • Fletcher Allen Health Care/ University of Vermont, Burlington, VT
  • Great Falls Clinic, LLP, Great Falls, MT
  • Hattiesburg Clinic, P.A., Hattiesburg, MS
  • Henry Ford Hospital, Detroit, MI
  • PriMed Physicians, Dayton, OH
  • Riverside Medical Group, Newport New, VA
  • Sharp Rees-Stealy Medical Group, San Diego, CA
  • St. Mary’s/Duluth Clinic Health System, Duluth, MN
  • ThedaCare, Inc., Appleton, WE
  • Vanderbilt Medical Center – Vanderbilt Medical Group, Nashville, TN

Current CTR Studies
CTR Staff
Community Partners

Center for Clinical Translational Research
(406) 238-2287
Fax: (406) 238-5193
Email: ctrtransresearch

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