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February 7, 2019

Heart Health and Compliance: Reflections for American Heart Month

Written by: Compliance blogger


February is a month filled with hearts. With the endless rows of heart-shaped boxes at the store, internal debates about the health merits of chocolate, and reminders of American Heart Month, you cannot escape discussions surrounding this important organ. Healthcare providers can keep hearts healthy for Valentine’s Day this year by working with patients to help manage their risk factors for heart disease, like high blood pressure or cholesterol.

Feel the Pressure? It’s a Major Risk Factor for Heart Disease

One of the primary factors that leads to an increased risk for heart attacks, strokes, heart failure, and even kidney disease is high blood pressure, a.k.a. hypertension. An estimated 1/3 of all adults in the United States have high blood pressure, but only about half of these individuals have it under control. One effective tool that patients can use to manage their high blood pressure is self-measured blood pressure monitoring (SMBP). In SMBP, individuals use personal blood pressure monitoring devices to measure their own blood pressure at home. The personal device a patient uses for SMBP stores their blood pressure readings, which can then be downloaded to a computer or transmitted to an electronic health record (EHR). Tracking SMBP readings is an important step for accurately relaying this information to any clinicians helping to manage one’s hypertension.

The Million Hearts program from the Centers for Disease Control and Prevention (CDC) offers some guidance for clinicians about helping patients monitor their blood pressure at home more effectively. For example, patient portals, paper logs, and even smartphone applications are all useful methods for patients to track their at-home blood pressure measurements. If your patients elect to use mobile phone apps to store information about their blood pressure readings, make sure that they are informed about potential privacy and security issues related to mobile devices and health apps.

One organization that has seen some success with the use of home blood pressure monitoring is the Department of Veterans Affairs (VA). Between 2000 and 2010, the VA successfully improved many veterans’ management of their high blood pressure by using a variety of tools and health interventions. One approach included in this program was the ability for veterans to use home blood pressure monitors and transmit their readings to providers via a patient portal.

High Cholesterol Becomes Higher Heart Disease Risk

Another major risk factor for heart disease, that everyone has certainly heard a lot about, is high low-density lipoprotein (LDL) cholesterol. According to the Centers for Disease Control and Prevention (CDC), people with high cholesterol have about twice the risk of developing heart disease compared to people with lower levels. Like high blood pressure, about 1/3 of adults in the United States have high LDL cholesterol. However, among individuals with this type of high cholesterol, only about 1/3 of them have it under control.

The two main techniques for treating high cholesterol are lifestyle changes or, in some cases, prescription medication. Lifestyle changes can include things like:

  • Dietary changes
  • Weight management strategies
  • Quitting smoking
  • Increasing physical activity
  • Stress management

While lifestyle changes take place largely outside of clinical settings, individuals still work closely with healthcare providers to monitor their progress and cholesterol levels.

Let’s Get Moving! Lifestyle Changes Can Help Reduce Heart Disease Risk

Quitting Smoking

One important lifestyle change that can help reduce an individual’s risk of heart disease is for them to stop smoking. Over time, a number of the chemicals in tobacco smoke cause damage to your heart, blood vessels, and blood cells. Even for people who do not smoke themselves, exposure to second-hand smoke can increase their risk for developing heart disease. Some strategies that can help people quit smoking include:

  • Talking with their doctor about medicines that can help with quitting
  • Seeking out social support for quitting
  • Using new activities to replace smoking, like going for a walk or other types of physical activity

Increasing Physical Activity

Another key change that can help reduce someone’s risk of heart disease is physical activity. In particular, regularly engaging in aerobic activity, which increases your heart rate, can benefit the health of both the heart and lungs. Aerobic activity can include:

  • Running
  • Swimming
  • Riding a bike
  • Dancing

If an individual already has a heart condition, it is recommended that they discuss physical activities with their doctor before beginning more strenuous exercises. The Office of Disease Prevention and Health Promotion has published tips for providers to talk with their patients about the physical activity in their daily lives. This resource also includes links to useful tools and materials about increasing one’s physical activity that providers can share with patients.

Patient-generated data, such as the information a patient might collect and share with their doctor about their progress in some of these lifestyle changes, raises important questions about what information might be relevant to a patient’s medical record. Invest in some continuing education programs from the American Institute of Healthcare Compliance to refresh your knowledge about how to code the various components of each patients’ heart health correctly. Staff members responsible for clinical documentation can also use our Comprehensive Clinical Documentation Improvement Training to stay up-to-date about heart disease risk factors and preventative measures that might be relevant for documenting medical office visits where heart health is discussed with patients.


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