Heart Disease and Stroke

The Prevention Status Reports highlight—for all 50 states and the District of Columbia—the status of key policies and practices that state health departments can use to reduce heart disease and stroke, including

The Problem

Cardiovascular disease—including heart disease, stroke, and other vascular diseases—is the leading cause of death in the United States.4

Policies & Practices

Implementation of electronic health records

An electronic health record (EHR) is a real-time, digital, patient-centered record that replaces paper charts. The US Department of Health and Human Services recommends that healthcare providers use government-certified EHR systems “meaningfully” by focusing on such aspects as engaging patients in their own care, sharing information among healthcare organizations, and providing support for decisions on national high-priority conditions.5

It is hoped that if healthcare providers meet such “meaningful use” criteria, it will lead to 1) creation of tools that measure healthcare quality to improve clinical and population health, 2) increased transparency and efficiency, 3) individuals empowered to access clinical information, and 4) more robust research data on health systems.5

EHRs should 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.6–9 Implementation of EHRs that meet meaningful use capabilities allows healthcare providers (e.g., physicians, nurses, pharmacists) to monitor the health of their patients proactively by tracking, in electronic form, heart disease and stroke risk factors.

Status of state implementation of electronic health records, United States (as of December 2012)

(State count includes the District of Columbia.)

± How the ratings were determined

± More information on this indicator

Pharmacist collaborative drug therapy management policy

Collaborative drug therapy management (CDTM) is team-based care managed by both a pharmacist and prescribing provider. Evidence shows that pharmacists are effective team members in managing control of chronic disease risk factors such as high blood pressure and low-density lipoprotein (LDL) cholesterol.1,2,9 A CDTM policy is a state legislative, regulatory, or other written policy that authorizes qualified pharmacists working within the context of a defined protocol to perform patient assessments; order drug therapy-related laboratory tests; administer drugs; and select, initiate, monitor, continue, and adjust drug regimens.10

State CDTM policies can increase medication adherence rates and improve health outcomes (e.g., reduced hemoglobin A1c, lower LDL cholesterol and blood pressure, fewer adverse drug events).1,2,9