CardX Hypertension Management (Jira PSS-2196)

The objective of the CardX Hypertension Project is to facilitate the communication of hypertension management data between clinicians and patients to increase the proportion of individuals with hypertension who are treated to goal. Hypertension affects 116 million adults in America, but only 25% of people diagnosed with hypertension are treated to their goal blood pressure. A standardized approach to hypertension management that emphasizes capturing data once and reusing it for multiple purposes will increase the proportion of patients treated to goal, improve clinical outcomes, reduce clinician burden, and enable more complete and accurate reporting.

This project will develop a FHIR Implementation Guide (IG) that will align and harmonize existing work to create a vendor-agnostic set of data exchange standards that enable interoperable, scalable, and accessible hypertension management. The IG will consist of FHIR profiles, extensions, transactions, and value sets needed to represent, query for, and exchange data for evidence-based management of hypertension. While this project has international relevance, the current implementers are U.S. based and therefore U.S.-specific terminologies and standards will be the focus for initial phases, with consideration for compatibility with universal realm standards and an eventual expansion to the universal realm in the future.

The project will follow a multi-phased approach:

Phase 1 (target for STU 1 ballot): The team will develop a set of profiles aligned with existing evidence-based guidelines that will standardize blood pressure readings, enabling the distinction between office-based and self-measured blood pressure (SMBP) readings, representing average blood pressure and critical evidence-based metadata on both individual and average blood pressure readings. Our goal is to enable meaningful exchange of blood pressure data between devices, personal health intermediaries, and clinical EHRs. This will shift the current paradigm of periodic office-based care to a patient-enabled, self-measured and data rich approach to hypertension management.

Phase 2: Building on the work and learnings from Phase 1, the team will develop workflows and model additional evidence-based elements supporting hypertension management in and out of the clinic, enabling bi-directional data exchange between patients and clinicians to manage hypertension. This could include data such as care goals, medications and other interventions, social history, and comorbidities. These contextual details will complement the blood pressure data addressed in Phase 1, enabling physicians and patients to make informed decisions to improving blood pressure control. Phase 2 may require more than one ballot following Phase 1, and the work is expected to heavily leverage ongoing HL7 projects around chronic disease management and physical activity.