Minnesota is Transforming Healthcare

18 Apr 2013

In Jan 2013 there was a report in the NEJM about aspirin prophylaxis in ischemic vascular disease to prevent heart attacks and strokes.(1) The data came from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey of the CDC. Patients seeing cardiologists were prescribed aspirin 46.9% of the time. Patients seeing primary care were prescribed aspirin 34.8% of the time.

These results made me wonder what the rate is in Minnesota, so, I asked Jim Chase at Minnesota Community Measurement (MNCM) what their data was showing. MNCM publicly reports aspirin prophylaxis as a component of the all-or-none composite measure for ischemic vascular disease called Optimal Vascular Care (OVC) at www.MNHealthcare.org. OVC requires aspirin prophylaxis, blood pressure control, lipid control, and documented tobacco free status.
THE RATE OF ASPIRIN PROPHYLAXIS IN MINNESOTA IS 95%. That is nearly three times the national rate, and, it is based on care of over 78,000 patients. Yes, that is seventy eight thousand! The 90th percentile in Minnesota is 100%. 
Based on the results practices in Minnesota are achieving, there is no doubt in my mind, transparency has the potential to transform health care. 
Minnesota has proven it is possible to achieve near perfect rates of aspirin prophylaxis. It has taken great courage and hard work to develop and publicly report these rates. 
National adoption and public reporting of the OVC measure would increase rates of aspirin prophylaxis, and improve the management of other modifiable cardiovascular risk factors as well. 
1) Parekh AK, Galloway JM, Hong Y, Wright JS. Aspirin in the secondary prevention of cardiovascular disease. N Engl J Med 2013; 368: 204-5.