Background: Hypertension is a common condition that impacts one in two Americans. Many people with hypertension, especially those with other health conditions, from minoritized communities, and/or with lower incomes, may struggle to keep their blood pressure under control¹. In collaboration with the American Heart Association and the University of Pittsburgh, this initiative focuses on improving hypertension management by implementing findings from a previous PCORI-funded study showing the comparative clinical effectiveness of clinic-based model of hypertension care to telehealth-based models combined with at-home blood pressure monitoring. View more information. 

Healthcare challenge: UPMC aims to enhance cardiovascular health by addressing poor blood pressure control, managing complex health conditions, and reducing disparities in cardiac care among patients. As a participant in PCORI’s Health Systems Implementation Initiative (HSII), UPMC was approved for a PCORI funding opportunity to use implementation science to promote evidence-based practice based on findings generated from PCORI-funded comparative clinical effectiveness research related to hypertension. PCORI’s HSII aims to reduce the estimated 17-year gap between evidence publication and clinical application.  

Goals:

• Develop and execute a feasible, scalable, and equitable approach for implementing PCORI evidence related to hypertension management within UPMC primary care delivery offices
• Demonstrate impacts of the practice changes on prioritized patient and health system outcomes, including blood pressure control, healthcare utilization, care quality and equity, across diverse patient subgroups.

Implementation Approach:

Population: Adult patients with hypertension seen at 130 UPMC primary care delivery offices, administrators, and clinical staff including physicians, advanced practice providers, nurses, pharmacists, medical assistants, practice-based care managers and others.

Methodology: 

Over a four year period, we will roll out a flexible and adaptable plan to improve management of patient blood pressure, allowing patients to choose how they want to engage in follow-up care (in-person, using technology, or a mix) and where to check their blood pressure, either at the clinic or at home. This plan will be introduced in three phases across the participating primary care sites.

We will examine existing clinical workflow and engage relevant groups, including care teams, patients, technology, and implementation science teams, to co-develop approaches for offering flexible, team-based hypertension care. UPMC will make changes to its existing infrastructure and workflows to ensure primary care offices can effectively deliver hypertension care that reflects the scientific evidence produced by PCORI.

These changes include:

• Creating easier and more workable processes for patients to get reliable blood pressure cuffs and submit at-home blood pressure values
• Effectively integrating patients’ submitted blood pressure values so that they can be easily monitored by care teams
• Adding training and education, making them easy to use for both patients and providers
• Designing new workflows to expand the makeup of the care team so that more clinic staff members will be trained and available to help primary care clinicians with blood pressure management.

References

¹Centers for Disease Control and Prevention. (2025, January 28). High blood pressure facts. High Blood Pressure. https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html

This project was funded through the Patient-Centered Outcomes Research Institute^® (PCORI®) Award HSII_UPMC_IMP-PS2.

The views, statements, and opinions presented in this webpage are solely the responsibility of the author(s) and do not necessarily represent the views of PCORI®