Penn Medicine Healthy Heart

Summary

To leverage access to patients across the primary care network, EPIC tools for identifying eligible patients, and the Way to Health platform to launch and enroll a program that will be evaluated in a clinical trial that is focused on changing patient behavior and powered to detect differences in improving blood pressure and cholesterol over 6 months for Penn Medicine patients in West/Southwest Philadelphia and Lancaster.

Eligibility

Inclusion Criteria:

* On the Penn Medicine Primary Care Service Line registry
* Last 2 Blood Pressure readings with Systolic Blood Pressure \>=140 from any outpatient encounter in the last 12 months AND
* ASCVD dx OR ASCVD risk score ≥10% OR Diabetes dx OR A1c ≥6.5 in last year OR Diabetes registry OR Last LDL ≥190 in past five years AND
* Not on a statinor PCSK9, Inclisiran OR on a Low-intensity/moderate-intensity statin) with LDL \>100

Exclusion Criteria:

* Patients on PCSK9 inhibitors
* Documented statin allergy/ or intolerance in the EMR
* Pregnancy
* Breast feeding
* Markedly shortened life expectancy including:

  1. metastatic cancer
  2. hospice
  3. End Stage Renal Disease
  4. Congestive Heart Failure
  5. Dementia
* Is a non-English speaker requiring a translator
* Patients who do not have a cell phone

Conditions3

Locations1 site

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