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• Background
• Goals
• Components
• The EvidenceNOW Model: Providing External Support for Primary Care
• Building Learning Health Systems in Primary Care
• EvidenceNOW Stories from the Field

Background

The ability to integrate and implement new discoveries into patient care creates a stronger, more effective health care system. But not all discoveries are equal. We turn to evidence to understand what works and how best to integrate effective approaches and treatments into patient care.

That’s why AHRQ launched EvidenceNOW: Advancing Heart Health, because changing medical practice is difficult, and people delivering care need proven methods to apply solid evidence to their patients’ situations. Primary care practices also need to know how to collect and analyze their own data to make sure they’re delivering the best care possible. The goal of this initiative was to strengthen our Nation’s primary care system and its ability to adapt, thrive, and improve patient care in an environment of discovery and change.

EvidenceNOW: Advancing Heart Health grew out of AHRQ’s commitment to promoting the delivery of high-quality, safe, high-value primary care, a decade of prior research and development on primary care practice transformation, and a mandate to disseminate and implement Patient-Centered Outcomes Research findings into practice.  Learn more about the origins of EvidenceNOW: Advancing Heart Health.

Goals

AHRQ launched EvidenceNOW: Advancing Heart Health, a $112 million effort and one of AHRQ’s largest primary care research projects to date, in 2015 with four primary goals:

• Help practices implement evidence to improve health care with a focus on heart health.
• Build practice capacity to receive and incorporate evidence in the future.
• Learn how external quality improvement support helps primary care practices improve the way they work and improve the health of their patients.
• Build and disseminate a blueprint of how to improve primary care with external supports.

Components

Cooperatives: This initiative was built around seven regional cooperatives that provided support services to small- and medium-sized primary care practices to help them integrate evidence-based approaches into patient care more quickly and effectively. With a focus on heart disease, the number one cause of death in the United States, the cooperatives offered services to the practices to help them improve delivery of heart health care. The seven Cooperatives worked with more than 5,000 clinicians at over 1,500 small- and medium-sized primary care practices (PDF) that serve about 8 million patients.  Each Cooperative also conducted a rigorous evaluation of its work.

National Evaluation Team: AHRQ awarded an eighth grant to create ESCALATES, a consortium of researchers that conducted an independent national evaluation of EvidenceNOW: Advancing Heart Health.

Technical Assistance Center (TAC): AHRQ contracted with the TAC to support the cooperatives and national evaluator. The TAC developed an online learning network for sharing best practices and problem-solving common challenges, and identified experts who provided guidance to grantees, conducted webinars, and provided additional technical assistance.

Download a fact sheet about the accomplishments of EvidenceNOW: Advancing Heart Health (PDF, 1.6 MB).

The EvidenceNOW Model: Providing External Support for Primary Care

The EvidenceNOW Model for providing external support for primary care practices is a realization of the concept of the primary care extension program (PCEP), which in turn is based on the successful 100-year-old Agricultural Extension Service. The EvidenceNOW Model recognizes that small- and medium-sized primary care practices, which represent the core of primary care for most Americans, often do not have dedicated staff, resources, or infrastructure for ongoing quality improvement activities. Just as small farmers have profited from the Agricultural Extension Service, these smaller practices can benefit immensely from an external quality improvement support system.

The EvidenceNOW Model of external support to primary care practices was implemented by the seven EvidenceNOW cooperatives. Each of them developed a customized set of external supports for their practices, combining five core services that are usually not available to smaller practices:

• On-site practice facilitation and coaching.
• Health information technology support.
• Shared learning collaboratives.
• Expert consultation.
• Data feedback and benchmarking.

EvidenceNOW: Advancing Heart Health focused on improving heart health, but the EvidenceNOW Model is applicable to other health issues of interest to practices and patients, such as unhealthy alcohol use and treatment or urinary incontinence. It can also be applied to improving complex processes of care, such as managing patients with multiple chronic conditions or increasing delivery of appropriate clinical preventive services.

Learn more about the EvidenceNow Model of providing external support for primary care.

Building Learning Health Systems in Primary Care

EvidenceNOW: Advancing Heart Health supports the evolution of primary care practices into learning health systems that continuously learn from available evidence and data to provide high-quality, safe, and efficient care.

Since its inception, EvidenceNOW: Advancing Heart Health has made a difference in individual practices’ day-to-day work, such as:

• Sharing evidence-based guidelines with thousands of primary care clinicians to improve care for patients.
• Linking hundreds of practices to regional health information exchanges.
• Developing dashboards so clinicians can use data to manage patient care more effectively.
• Coaching care teams on ways to identify high-risk patients to better target evidence-based preventive services like aspirin and cholesterol medication.

This initiative is shining a light on the types of supports that help primary care practices achieve improved health outcomes—including how best to spread the results of patient-centered outcomes research to primary care practices and how to assist practices in using this research to deliver better care to their patients.

Ultimately, findings and lessons learned from EvidenceNOW: Advancing Heart Health will create a blueprint for strengthening the Nation’s primary care system and improving its capacity to deliver high-quality, evidence-based, patient-centered care. This blueprint is the EvidenceNOW model of external support.

Stories From the Field

Stories from the Field provide an intimate look at some of the practices that participated in EvidenceNOW: Advancing Heart Health and the positive impact the initiative has had on practices and patients.

Learn more at  Stories From the Field

Dowload the Fact Sheet: EvidenceNOW: Bridging Research and Practice in Primary Care (PDF, 1.6 MB)