0920-0976_Change Request Justification_6_07_21

Change Request

Million Hearts Hypertension Control Challenge 0920-0976

This is a revision. OMB approval is requested for 3 years. Proposed changes are outlined below.

Summary

We request OMB approval to update the Data Collection Tool #3: The Interview Guide for collecting success stories of the Hypertension Control Champions OMB-approved tool. The Interview Guide will provide a template for sharing and disseminating success stories.

Background and Justification

Since 2012, the HTN CC initiative has recognized 133 Hypertension Control Champions in 40 states for reaching an average of over 70%-80% control. These experts have shared the keys to their success: a combination of priority-setting, treatment protocols implemented by care teams, staff incentives, out-of-office blood pressure monitoring (including Self-Monitored Blood Pressure (SMBP) for treatment of hypertension), leveraging health Information Technology (IT) solutions, and more.

The HTN CC identify, celebrate, and share lessons learned from clinicians, practices, and health systems that have been able to focus ad successfully monitor and improve hypertension control.

The proposed changes to the Interview Guide are provided (Attachment 5). We suggest minor modifications to previously approved OMB guide as noted. The minor changes are to reduce the burden on the participant, ease on the program, and standardization in collection and dissemination in a template form. The suggested edits improve the critical information shared and the ease in answering questions from clinic practices and clinicians from whom the information is being requested.

Burden Estimate

No change to the burden estimate is requested.

Effect of Proposed Changes on Currently Approved Instruments and Attachments

Non-substantive change for data collection.

OMB approval is requested, effective immediately.

Appendix A

Original interview guide	Proposed Questions
Introduction	Interview Guide: Success Story
Congratulations on your selection as a Million Hearts® Hypertension Control Champion. I am (name) with (organization) talking with you on behalf on the Million Hearts® Initiative. Thank you for making time to talk me today. The primary purpose of the Million Hearts® Hypertension Control Challenge is to identify providers such as yourself who achieve exemplary hypertension control rates and then to share the strategies and processes you have adopted with the healthcare community to improve practice. The expectation of Million Hearts ® is develop a “success story” describing your practice and patient population in broad terms, your documented hypertension control rates, and the strategies adopted by your practice (healthcare system) to provide exemplary care for your hypertensive patients. Your practice will be named in the publication. To facilitate this goal, Million Hearts® has scheduled this interview. I expect the interview to last about 1 hour, and may ask you to review any final products which may take another 1 hour. You may stop the interview at any time and refer us to a colleague or employee who may be better able to provide the information we are requesting. However, refusal to allow any staff to participate in the interview and documenting of strategies may result in a loss of some of the benefits of recognition. You will have an opportunity to review and comment on any products developed as a result of this interview. This data collection is approved under Office of Management and Budget # 0920-0976. We have three primary questions and will follow up some of your responses with a request for additional details. To accurately document your successes, we would like to record this session. Is that alright?	Congratulations! Million Hearts® has selected your team as a good example of attaining impressive hypertension control numbers and would like to highlight your practice in a short success story to be featured on the Million Hearts® website. We hope to weave together your experience with that of fellow practices and health systems that have also demonstrated success in this area in order to educate and inspire other health care professionals to adopt similar tactics. Instructions: Please use this worksheet to describe your challenges, approach, and strategies in successfully reaching an 80% control rate among your patients with hypertension. Be as specific as possible. Million Hearts® and Palladian Partners will use the completed questionnaire to develop your success story.
	Champion Information
May we begin? 1.       Please describe how you identify and track patients with hypertension.	Name of health care professional/practice/health system: Primary point of contact (name, title, email, telephone):
	Patient Demographics
Please describe how you calculated the hypertension control rate for your practice or (healthcare system). Are any groups or individuals excluded from the analysis?	How many total patients and adult patients with hypertension do you serve annually? Are there other clinics in your area? Describe some of the characteristics of your hypertensive patient population (e.g., uninsured or under insured, low English proficiency, comorbidities) (150–250 words).
Please describe the processes or systems you have adopted in your practice (healthcare system) that you believe contribute to the exemplary blood pressure control achieved by your practice (healthcare system):
Prompt	Challenge and Approach
Prompt as needed: Have you incorporated healthcare extender as team members into the practice such as pharmacists, community health workers, or others? Please describe the staff you have engaged ad their role in the healthcare team. Do you use electronic medical records (EMRs)? Please describe how you use EMRs in your practice to identify and treat patients with hypertension. Please describe features of the EMR that are most useful to you. Do you have reminders or treatment prompts outside of EMRs? Please describe the reminders and/or prompts used and unique practices associated with them. Do you provide patient or staff performance incentives? Please describe them.  Have you identified and make use of community-clinical linkages? Please describe them? Have you partnered with community resources for meet patient needs? Please describe the partnership and the benefits to your patients.	Describe the unique challenges you or your practice encountered on your journey to hypertension control (150–250 words). What are your patients’ biggest barriers to hypertension control? Describe your or your team’s approach to hypertension control (150–250 words). Describe quantitative and/or qualitative results your team saw after implementing your approach (e.g., percentage of patients with hypertension under control, changes in health outcomes, other benefits measured) (150–200 words).
	Strategies for Success
Is there anything else you believe has contributed to your exemplary hypertension control rates that you would like to add? Thank you for participating in this interview. We expect to have draft materials based on this conversation for you to review by: _________________________________________. If you have any questions, or would like to add information to your interview, please contact ____________ at ____________ (phone and e-mail).	List 3–4 of the most important success strategies you used to overcome the challenges mentioned above. What resources did you use to achieve greater hypertension control in your patients? What advice would you give other clinicians or practices about how to achieve hypertension control? Share 1–2 quotes from staff or team members (include attribution and affiliation). Quotes may be modified for length or style in the final success story.
	Program Photos Please include 1–3 high-resolution photos (e.g., of staff members or activities) as separate attachments with your completed questionnaire. Provide consent forms for any identifiable individuals in the photos.