Frequently asked questions

The American Medical Association (AMA) is the largest physician association in the United States and a powerful ally to physicians in patient care. We actively represent physicians with a unified voice, drive the future of medicine, remove obstacles that interfere with patient care and lead the charge to confront public health crises.

Cardiovascular disease (CVD) is the leading cause of death in the United States and high blood pressure (BP) is a major risk factor for developing CVD. Effective BP control is a key opportunity in preventing heart attacks and strokes.

AMA MAP Hypertension is a high-impact evidence-based quality improvement (QI) program, providing health care organizations (HCOs) a clear path to significant, sustained improvements in blood pressure (BP) control. AMA MAP Hypertension has been shown to help HCOs achieve—and sustain—a 10 percentage point increase in hypertension control.¹

Improving BP control is one of the most effective ways to improve patient health within your HCO. Hypertension significantly increases the risks of heart, brain, kidney and other diseases. Together, these conditions contribute to nearly 850,000 deaths annually in the United States—many that could be prevented with better blood pressure control.²

In the United States, blood pressure control has been declining over the last 5 years. Now, less than half of adults with hypertension have it controlled.

_{AMA MAP BP is shown to increase BP control rates by 10 percentage points in 6 months with sustained results at 1 year.¹ These improved high blood pressure outcomes may lead to better quality scores and opportunities for streamlined reimbursement.}

The MAP quality improvement (QI) framework is named for its 3 key elements:

Measure accurately: Through structured training for clinical staff and workflow modifications, the program improves the ability to obtain accurate and representative BPs with minimal disruption to existing patient flow.

Act rapidly: The clinical team will be equipped to act using treatment protocols that incorporate guideline-directed treatment, frequent patient follow-up and workflows for outreach to uncontrolled patients.

Partner with patients: Shared decision making, patient satisfaction and improved outcomes can be enhanced through the use of collaborative communication, improving treatment adherence and promoting the use of self-measured BP monitoring.

In collaboration with your organization’s leadership, quality improvement, information technology, clinical and operations teams, the AMA will provide planning and support during program setup and implementation, which can include the AMA MAP Hypertension Dashboard, to help your organization reach its desired objectives.

AMA experts will provide coaching to help:

• Train and assist your clinical team on AMA MAP Hypertension. With ongoing communication and support from AMA, designated clinical team members will serve as practice coaches to implement the program
• Co-lead a kickoff event presentation(s) with your faculty, assisting in the creation of content for these events
• Assist in assessing your practice sites’ readiness to implement the program
• Assist in evaluating and developing a plan for ongoing improvement and spreading it throughout your HCO
• Support your clinical team(s) throughout the implementation process
• Share observations and insights as appropriate

AMA experts also provide support with the AMA MAP Hypertension Dashboard:

• Provide analytics and technical support to incorporate AMA MAP Hypertension performance metrics into new or existing dashboards or data distribution processes
• Collaborate to validate data in performance metrics
• Collaborate to analyze performance metrics and provide a dashboard with aggregate results for your leadership teams and actionable, patient-level information for the clinical team

The resources offered by the AMA as part of the program are provided at no cost to HCOs. To implement the program, HCOs can expect to incur equipment costs if the decision is made to purchase new BP measurement devices as well as incremental allocations in clinical, quality improvement and information technology staffing.

AMA MAP Hypertension involves pre-program planning, prior to implementation.

Pre-program planning includes:

• Identifying your team and implementation infrastructure
• Coordinated support from AMA clinical, clinical operations, data and dashboard and analytics teams.

Once your organization has launched AMA MAP Hypertension, the AMA will support your organization for 6 to 12 months. After this time, your organization will build on learnings to sustain and scale the program.

If the program was implemented as a pilot, you will also use these learnings to roll the program out system-wide.

Depending on the size and complexity of the HCO, it can take 6 to 12 months to make AMA MAP Hypertension a sustained quality improvement program within your organization.

• Scope of work and contracting: 4 to 8 weeks
• Pre-launch discovery and planning: 4 to 12 weeks, depending on the availability of an organization’s team leads
• Program Kickoff: approximately 6 hours total (various training sessions)
• Post-launch support from the AMA: 6 to 12 months
• Scale and sustainability: ongoing for your organization

The AMA MAP Hypertension Dashboard is an integral part of the program, providing physicians and clinics access to monthly reports tracking 5 key performance metrics:

At a glance, these metrics show the results the organization is achieving with the program and assist in monitoring to ensure results are sustained over the long term.

• Overall Outcome: The percentage of eligible patients whose BP is adequately controlled at their most recent encounter. This metric includes office-based and self-measured blood pressures (SMBP).
• Confirmatory Blood Pressure: The percentage of adult patient encounters in which an initial (intake) uncontrolled BP is confirmed by a repeated measurement at the same encounter.
• Therapeutic Intensity: Average number of medications (at standard dose or higher) that are prescribed to patients with uncontrolled BP.
• SBP Change After Therapeutic Intensification: The average change in systolic BP (SBP) following hypertension medication intensification for patients with uncontrolled BP.
• Visit Follow-up: The percentage of patients with an uncontrolled BP having follow-up visit within 30 days.

At a glance, these metrics show the results your organization is achieving with the program and assist in monitoring to ensure results are sustained over the long term.

The AMA MAP Hypertension Dashboard is populated using your organization's EHR data. The dashboard is cloud-based and you can embed a weblink  in your EHR for one-click viewing of the dashboard.

Data is stored in a HIPAA-compliant and HITRUST-certified Amazon Web Services (AWS) environment with managed services provided by ClearDATA. All data is encrypted, both while at rest and while in transmission. All reports with patient data sent to providers is encrypted and requires two-factor authentication.

All access to data is stringently managed. No data that is transmitted to the AMA and used to populate your AMA MAP Hypertension Dashboard is stored in systems accessible via the Internet. All system access is password protected and logged. The system used to store your organization's data is protected by firewalls for all users and multiple layers of protection and authentication for development staff. Every 6 months, the system is subjected to penetration testing to ensure the information remains secure.

We are working with dozens of HCOs, including federally qualified health centers, academic medical centers and some of the largest multi-state health systems in the United States.

AMA MAP Hypertension has been studied in primary care settings with results published in peer-reviewed manuscripts. In those studies, BP control improved 10 percentage points or more in 6 months.¹

Results at your HCO may vary depending on level of organizational prioritization, buy-in from clinical and operations leaders and teams, IT engagement and execution of the program. We are committed to helping you achieve the maximum benefit for your patients, clinical teams and organization.

There can be a significant ROI in terms of patient health. Improved BP control rates/lowering blood pressure reduces the impact of cardiovascular disease (heart attacks, strokes, heart failure, vascular disease) as well as chronic kidney disease, mild cognitive impairment and possibly dementia

There may also be significant ROI from a financial perspective. Improved performance for blood pressure control measures may be used to determine payment in some private payor plans or in shared savings plans and accountable care organizations. By moving toward remote management of hypertension, organizations can free schedules from a number of low-level evaluation and management (E/M) visits, opening capacity for patients with higher acuity or more complex care.