EvidenceNOW, at $112 million, is the largest research study funded to date by the Agency for Healthcare Research and Quality (AHRQ) and is designed to transform cardiovascular healthcare delivery in the United States. By developing critical infrastructure, EvidenceNow will help thousands of primary healthcare providers translate innovative medical research findings into practice, improving the heart health of millions of Americans.
Heart disease is the leading cause of death for men and women in the United States. EvidenceNOW aims to improve delivery rates of the ABCS of cardiovascular disease preventive services: Aspirin use by high-risk individuals, Blood pressure control, Cholesterol management and Smoking cessation. New evidence continually surfaces about how best to deliver the ABCS. The goal of EvidenceNOW is to ensure that primary care practices, which often lack the resources to apply the latest breakthroughs in ABCS adoption strategies, have the latest evidence and that they use it to help their patients live healthier and longer lives.
AHRQ awarded eight grants to accomplish their ambitious and far-reaching national goal. Seven grants were awarded to regional cooperatives, and one grant was awarded to ESCALATES as a national evaluation of the overall initiative and work done by each of the cooperatives.
Regional grants, EvidenceNOW Cooperatives
AHRQ EvidenceNOW provided grants to seven regional cooperatives composed of public and private health partnerships and multidisciplinary teams of experts. Each cooperative will recruit 250-300 small and medium-sized primary care practices and provide them with quality improvement services typically not available to small practices. The services include onsite practice facilitation and coaching, expert consultation, shared learning collaboratives, and electronic health record support.
National Evaluation grant, ESCALATES
The ESCALATES team will study which practice supports and quality improvement strategies are most effective in improving the implementation of new evidence by evaluating the work of the seven Regional Cooperative. Learn More About ESCALATES.
“Over the past five years, our team and partners in the Tri-State (Illinois, Wisconsin, and Indiana) region have helped primary care practices, particularly small- or medium-sized independent practices, move from paper to Electronic Health Records (EHRs). This transformation has presented our primary care providers with new opportunities, for example, to use their EHRs to objectively track and improve the quality of care they provide, or to engage their patients in self-care. But we’ve also seen current market forces drive practice consolidation because smaller practices often lack the resources and infrastructure to engage in quality improvement initiatives or the size to negotiate sustainable reimbursements. Our project aims to bring together a motivated team of regional collaborators to explore, develop, and disseminate data and population health-driven strategies to help primary care practices maintain their independence and deliver high-quality, well-coordinated, and sustainable health care, with a primary focus on the ABCS of cardiovascular disease prevention.”
Abel Kho, M.D., M.S.
"The NYC Cooperative will enroll more than 250 practices across NYC in one of the largest and most ambitious efforts yet to rigorously test strategies for translating evidence-based guidelines for prevention and treatment of CVD into improved provider practice, leading to improved health outcomes among low socioeconomic status and minority populations. To achieve the study goals, the Cooperative has created an innovative public- private partnership that brings together a multidisciplinary group of health services researchers (NYU) and health care delivery and public health professionals (PCIP and CHCANYS) who are on the frontline of transforming primary care practices to improve healthcare quality and outcomes among patients at highest risk for CVD-related morbidity and mortality. By applying an implementation science framework, we expect to provide critical new knowledge to facilitate the widespread implementation, dissemination, and sustained utilization of evidence-based guidelines for prevention of CVD across the U.S. and to advance Healthy People 2020 objectives."
Donna Shelley, M.D., M.P.H.
New York City
"I’ve cared for many people throughout my career who suffered the debilitating effects of a heart attack or stroke way too early. Because of the lack of sophisticated information systems and processes that could quickly identify risk and prioritize new evidence for care, many of these folks missed opportunities that could have prevented the paralysis, shortness of breath, and death that often resulted from premature disease. Despite solid progress over the last few years, small primary care practices often lack the in-house infrastructure and technical expertise to rapidly apply new evidence and new principles to specific populations at high risk. This problem is especially important in cardiovascular disease, the leading cause of death in North Carolina. By partnering with these practices to build in the needed supports, we have the potential to prevent thousands of heart attacks, strokes, and deaths within a few short years. This kind of approach is what a learning health system needs to be about, and I'm thrilled to work with colleagues in practice across the State to achieve that dynamic in healthcare."
Samuel Cykert, M.D.
“Our goal is to build a sustainable infrastructure for ongoing improvements in the delivery of primary care in the Pacific Northwest that contributes to the Triple Aim, improves the experiences of those who provide care within the practice, and prepares primary care providers for value-based care reimbursement models. We will make a substantial contribution to the field of implementation science by advancing understanding of how to effectively provide external practice support to build QI capacity and improve cardiovascular risk factors for a substantial number of people served by small- to medium-sized primary care practices.”
Michael Parchman, M.D., M.P.H.
“The Oklahoma Primary Healthcare Improvement Cooperative (OPHIC) is a new model of practice-based learning and improvement that brings research findings and innovations into the workflow of primary care practices. The OPHIC plan will make available physician coaches (academic detailers), information technology advisors (Regional Extension Center technicians), and in-practice facilitators (practice enhancement assistants) who will manage the change process, data, and role and responsibility changes in the practice.
The OPHIC is one component of the larger Oklahoma Primary Healthcare Extension System, which is building an infrastructure of primary care practices, county-level public health and community action services, the public sector, and business community into a County Health Improvement Organization (CHIO). The CHIO will bring community-level expertise and resources to assist primary care physicians in meeting their targets for prevention of cardiovascular disease.
A further unique feature of this project is the incorporation of the two Health Information Exchange Organizations (HIEOs) in Oklahoma (MyHealth and Coordinated Care Oklahoma) to provide practice-level quality reports on cardiovascular disease prevention and improvements in utilization and patient outcomes. The analytics services provided by the HIEOs can be used to automate data collection and reporting in a seamless fashion for quality improvement and for research in measuring the outcomes and characteristics of practices across the state.’’
Daniel Duffy, M.D.
“Evidence Now Southwest will allow for two separate but related efforts in Colorado (the Colorado Health Extension System) and New Mexico (Health Extension Rural Offices) to build on their existing strengths by learning from each other and to further extend their support of practice transformation and community health improvement efforts across our two States. The project will also allow us to test the impact of patient engagement on practice transformation efforts.”
Perry Dickinson, M.D.
“This AHRQ initiative is crucial for ensuring that primary care practices are delivering optimal care because they have adopted best practices. In Virginia, we will work to restore the joy of practice for hundreds of primary care offices. This is essential if we aspire to achieve the Triple Aim for population health care.”
Anton Kuzel, M.D., M.H.P.E.