Healthy Hearts in the Heartland (H3)

Healthy Hearts in the Heartland (H3) was a federally funded research program working with small practice clinics in Wisconsin, Illinois, and Indiana to implement and evaluate quality improvement strategies for cardiovascular care. H3 sought to identify the best practices, tools, and supports needed for small clinic settings to improve the heart health of their patients. This type of work is becoming common in large health systems; small clinics had the opportunity to pioneer how this quality improvement work can be done effectively in the Midwest. Participating clinics received support from experienced practice facilitators for 12 months, followed by monitoring and data collection services for an additional six months. Educational webinars were offered monthly.

Why Did Practices Participate?

H3 was a research project that helped practices:

• Strengthen prevention for heart disease and stroke by focusing on Million Hearts ABCS – Aspirin, Blood pressure control, Cholesterol management and Smoking cessation;
• Build or enhance infrastructure to report and use quality data to improve care;
• Generate new opportunities for providers to earn continuing medical education (CME) credits and maintain board certifications;
• Prepare to take advantage of fee-for-service reimbursement opportunities and quality-based incentive programs; and
• Prepare for the healthcare system’s shift toward value-based reimbursement.

We wholeheartedly thank the 226 small practices that participated in the project!

Publications and Presentations:

• Implementation Science & Informatics to Improve Cardiovascular Care in Primary Care Settings (IPHAM seminar | February 2022)
• Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study (Read on Implementation Science | April 2021)
• Challenges to electronic clinical quality measurement using third-party platforms in primary care practices: the healthy hearts in the heartland experience (JAMIA Open | December 2019)
• Design of healthy hearts in the heartland (H3): A practice-randomized, comparative effectiveness study (Contemporary Clinical Trials | August 2018)

H3 was one of seven regional cooperatives established by EvidenceNOW to provide quality improvement services typically not available to small primary care practices. Advancing Heart Health in Primary Care, an initiative of the Agency for Healthcare Research and Quality (AHRQ), funded the project.

Principal Investigator:
Abel Kho

Funding:
Funding for this program was provided by the Agency for Healthcare Research and Quality (AHRQ). AHRQ#: HS 023921-01.

Timeline:
H3 ran from winter 2016 to 2020. Dissemination efforts are ongoing.

IRB Number:
STU00201720

Collaborators:
AllianceChicago
American Medical Association
Illinois Health IT Regional Extension Center/Northern Illinois University
Illinois Department of Public Health (Office of Policy, Planning and Statistics)
MetaStar
NowPow
Purdue Healthcare Advisors/Purdue University
Telligen
University of Chicago/ UChicagoMedicine South Side Health and Vitality Studies