JMIR Publications

ABSTRACT

Background:

Hypertension management of racial and ethnic minorities (e.g., African American/Black) in primary care is highly relevant. However, evidence on whether or how Electronic Health Records (EHR)-driven approaches can help to improve hypertension management for patients of racial and ethnic minorities in primary care remains scarce.

Objective:

This review aims to examine the role of the EHR in supporting interventions to strengthen hypertension management of racial and ethnic minorities in primary care.

Methods:

A search strategy based on the PICO guidelines was utilized to query and identify peer-review articles on the Web of Science and PubMed databases. The search strategy was based on terms related to racial and ethnic minorities, hypertension, primary care, and EHR-driven interventions. Articles were excluded if the focus was not hypertension management in racial and ethnic minorities or if there was no mention of health record data utilization.

Results:

A total of 29 articles were included in this analysis. Regarding populations, Black/African Americans represent the largest population (26 studies), followed by Hispanic/Latinos (18 studies), Asian Americans (7 studies), and American Indian/Alaskan Natives (2 studies). No study included Native Hawaiian/Pacific Islander. However, the EHR was used to identifying patients (n=25), drive the intervention (n=21), and Monitoring results and outcomes (n=17). Most often, EHR-driven approaches were used for health coaching interventions, disease management programs (DMPs), clinical decision support systems (CDS), and best practice alerts (BPA). However, out of 8 EHR-driven health coaching interventions, only 3 reported significant results. In contrast, all included studies related to CDS and BPA applications reported significant results with respect to improving hypertension management.

Conclusions:

This review identified several use cases on how the EHR can meaningfully support interventions to strengthen hypertension management of racial and ethnic minorities in primary care. In particular, clinical-based interventions implementing CDS and BPA applications have shown promising results. However, more research is needed regarding community-based interventions as well as focusing on Asian Americans, American Indian/Alaskan Natives, and, especially, Native Hawaiian/Pacific Islanders.