The Healthy Hearts project is supported by the Association for State and Territorial Health Officials, the Centers for Disease Control and Prevention and endorses the Million Hearts® initiative.
Heart disease and stroke prevention efforts coupled with effective disease management can reduce the incidence of heart attacks and strokes, cut the number of deaths from this disease, and relieve some of the disability suffered by heart attack and stroke survivors. The Illinois Department of Public Health is committed to preventing cardiovascular disease in communities across the state. These prevention efforts are also an integral part of the Illinois State Health Improvement Plan.
Launched in 2012, Million Hearts® is a nationwide initiative to focus, coordinate, and enhance cardiovascular disease prevention activities across the public and private sectors to prevent 1 million heart attacks and strokes by 2017. Million Hearts® focuses on ABCS: Aspirin use in high risk populations, Blood pressure management, Cholesterol management, and Smoking cessation
In support of the objectives of Million Hearts®, Healthy Hearts uses the following strategies to impact cardiovascular disease management:
- Use of data driven quality improvements in collaboration with local health departments and rural or federally qualified health clinics.
- Strengthening public health/ clinical linkages for a population health approach to cardiovascular disease.
- Implementing self-management tools at the community level.
To improve health in communities, clinicians and public health need to understand population level health and how it impacts the care of an individual. Healthy Hearts integrates electronic health record data and population health data to create a robust picture of community health.
Healthy Hearts uses open source software designed by the Office of the National Coordinator (ONC): popHealth®. Housed on the Public Health Node, this tool uses electronic health record information to create dashboards reporting each providers’ use of national guidelines. popHealth® is Meaningful Use certified, and its reports measure the Clinical Quality Measures needed for Meaningful Use. Clinics are able to use the dashboards to identify patients in need of additional services, follow up calls or referrals to community services for self-management. Clinic leadership uses dashboard reports to review workflow, patient education, and provider knowledge in order to improve the quality of care.
In addition, clinical dashboards are augmented with population level data analyzed by IDPH epidemiologists. County and zip code level data and GIS maps are used to identify “hot-spots” for intervention. These data are used to enhance local collaboration. Using IPLAN, community needs assessment, local health departments, providers, and community agencies collaborate to determine how best to improve the state of cardiovascular disease in their county.
IDPH brings quality improvement expertise to guide the collaborative to implement local improvement activities. Such activities have included:
- Training church volunteers in accurate blood pressure management and offering blood pressure monitoring sessions after church services
- Convening local providers to determine community standards for hypertension management and referrals
- Activating Chronic Disease Self Management Programs to help people learn how to manage their lifestyle and disease
- Improving referrals between providers and community agencies for medication management and patient education
Through effective collaboration and the above activities, 2 counties have already improved hypertension management in over 2500 people diagnosed with hypertension.
Cardiovascular Disease in Illinois
Heart disease refers to several diseases of the heart. The most common type of heart disease is coronary artery disease, which can cause a heart attack. Heart disease is the single leading cause of death in Illinois and the United States and is responsible for nearly 80 percent of cardiovascular deaths. In 2009, nearly 25,000 deaths in adults age 35 and older in Illinois were due to heart disease.
There are several risk factors that can increase the likelihood of developing cardiovascular disease. Some risk factors cannot be changed, such as family history, gender, ethnicity and age. Other risk factors can be managed to help prevent cardiovascular disease. These risk factors are high cholesterol, high blood pressure, smoking, diabetes, obesity, physical inactivity, poor nutrition, and excessive alcohol use.
When compared to the United States, Illinois has a higher prevalence for the risk factors of high cholesterol, obesity, poor nutrition, and excessive alcohol use. Illinois has a lower prevalence of the risk factors of high blood pressure, smoking, and physical inactivity than the United States.
The U.S. Centers for Disease Control and Prevention National Heart Disease and Stroke Prevention Program defines the ABCS of cardiovascular health as Aspirin therapy, high Blood pressure (including sodium reduction), high Cholesterol, and Smoking cessation. The CDC NHDSP guideline, Strategies to Address the “ABCS,” describes screening tests and behavioral changes around the ABCS that can be used to help diagnose, control and prevent further damage from cardiovascular disease.
More information on heart disease in Illinois is available in the 2013 report: The Burden of Cardiovascular Disease in Illinois
Illinois’ Heart Disease and Stroke Prevention Program site contains more data and resources: Illinois' Heart Disease and Stroke Prevention Program