SHC and Cardiovascular Disease

(Atrial Fibrillation and Heart Failure)

CVD remains the number cause of death of Americans disproportionately impacting many racial and ethnic groups that have higher rates of CVD and the associated risk factors. Racial and ethnic minority populations face more barriers to diagnosis and care, receive lower-quality treatment, and experience worse health outcomes than their white counterparts. Building off of the SHC-QIE model, SHC is fully engaged in multiple partnerships aimed at addressing these disparities in CVD which are often linked to a number of complex factors such as income and education, physiological factors, access to treatment, and communication barriers. Current SHC CVD initiatives include:

• Identification and Screening for Patients with Nonvalvular Atrial Fibrillation (NVAF): A Demonstration Project in Performance/Quality Improvement. This initiative promotes prevention, equity, and evidence-based care by using NMQF’s powerful geo-mapping technologies to identify population need and incorporate both health system change and support along with team-based primary care practice quality improvement to realize a population health goal of decreasing the number of people with undiagnosed/untreated Nonvalvular Atrial Fibrillation (NVAF), especially those with increased risk factors, such as age greater than or equal to 65 years, heart failure, hypertension, diabetes, prior stroke or embolism, and vascular disease.

• Heart Failure QIE Program to promote evidence-based and person-centered care for African Americans with HF to improve patient engagement to enhance treatment adherence and access to cardiac rehabilitation services. This initiative will convene primary practice team leaders and local hospital and cardiology experts to be trained in evidence-based, person-centered HF care, from hospital discharge through ambulatory management.