A Heart Health Q&A with Cynthia Pamon

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Cynthia Pamon, CMS
Cynthia Pamon, CMS

Cynthia Pamon is a registered nurse with many years of experience in health care. Currently, she serves as the Centers for Medicare & Medicaid Services’ Program Lead for the QIO Program’s improving the health status of communities initiative. She also is the Government Task Leader for the Home Health Quality Improvement National Initiative. Previously at CMS, Ms. Pamon was the lead for the Disparities and the Cardiac Population Health Programs, and the Advancing Excellence in America’s Nursing Homes campaign. Prior to her government service, Ms. Pamon was the manager of case management for Sierra Military Health Services., Ms. Pamon is a certified case manager (CCM) and has a Bachelor of Science degree in Nursing (BSN) from the University of Illinois, as well as a Masters in Health Care Administration (MSHCAD) and a Masters in Business Administration (MBA) from the University of Maryland University College.

Q. What led to CMS’ decision to focus on reducing cardiac health care disparities over the coming five years?

A. Over the next five years, our goal is to improve beneficiaries’ cardiovascular health through heart attack and stroke prevention, particularly among African-Americans, Hispanics, Asian-Americans, Pacific Islanders and any other population groups that are disproportionately affected.

Our decision to focus on cardiac health was an easy one. Besides being the number one cause of death in the U.S. according to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for people of most ethnicities, including African-Americans, Hispanics and whites. The American Heart Association has calculated that heart disease and stroke cost our nation over $312 billion per year in health care costs and lost economic productivity.

These statistics and other cardiac mortality data make it clear that we have to improve our nation’s heart health.

Q. Home health agencies will play a key role in the CMS QIO Program’s efforts to improve cardiac health. Tell us about their role in helping keep beneficiaries healthy and how Quality Innovation Network-QIOs (QIN-QIOs) will be engaging and working with them.

A. Home health professionals – such as registered nurses and licensed therapists – play an important role in helping beneficiaries learn how to adopt preventive health practices and stay out of the hospital. In the fall of 2014, the QIN-QIOs began working with home health agencies (HHAs) willing to report through the Home Health Quality Improvement Cardiovascular Data Registry (HHQI-CDR) on heart attack and stroke prevention initiatives. With support from the HHQI National Initiative, the QIN-QIOs will work with the HHAs to help them use evidence-based best practices for patient self-management based on the ABCS supported by Million Hearts®: Appropriate aspirin therapy use, Blood pressure control, Cholesterol management and Smoking screening with cessation counseling. We are particularly interested in partnering with home health agencies that serve African-Americans, Hispanics and other groups that suffer disproportionately from cardiac health problems.

Q. The QIO Program has established a fruitful partnership with the U.S. Department of Health and Human Services (HHS)’ Million Hearts initiative over the past few years. How will that partnership evolve over the coming years? 

A. We are a proud supporter of Million Hearts’ goals to prevent one million heart attacks and strokes by 2017, and we appreciate the resources and support they have provided to the QIO Program in recent years. Moving forward, we plan to expand our work by requiring data-driven quality improvement and clinical outcome reporting on all four of the Million Hearts’ ABCS measures. In addition to working with the HHAs, the QIN-QIOs may work with physician’s offices, clinics, partners and stakeholders to facilitate outreach and education in various target communities. Also, the QIN-QIOs will focus on the blood pressure control priority measure by encouraging the use of hypertension protocols and employ other technical assistance strategies as needed. Clinicians, patients, partners and stakeholders can expect to learn and share information through QIN-QIO-sponsored webinars, learning and action networks, in-person and phone meetings, and via social media.

Q. What are some innovative or unique ways in which QIN-QIOs have engaged with patients in recent years to improve their heart health?

A. Two particular examples come to mind. The Arkansas Foundation for Medical Care (AFMC) – now part of the TMF Quality Improvement Network (TMF-QIN) – sought to improve cardiac health and reduce disparities by connecting with churches in Arkansas. AFMC’s Bless Your Heart: Faith-Based Ministries” toolkit has helped improve the well-being of many congregants. Meanwhile, in California, Health Services Advisory Group (HSAG) – another QIN-QIO – partnered with the American Heart Association on a Check.Change.Control blood pressure program, which helped several beneficiaries make lifestyle changes to improve their cardiac health.

Q. How will QIN-QIOs engage physician practices to optimize health information technology to improve cardiac health outcomes?

A. QIN-QIOs will be working with physicians who have agreed to participate in the Physician Quality Reporting System (PQRS) program and report on the ABCS via electronic health records (EHRs). By effectively communicating and sharing concrete examples of the benefits of EHR usage on an ongoing basis, QIN-QIOs can successfully engage physician practices in using them. As many providers know, EHRs help cut down on paperwork and enable physicians to have patient information at their fingertips for better coordinated and efficient patient care. Also, EHR systems permit tracking, secure sharing, and communication of data with patients and other clinicians. 

Q. Anything else you’d like QIO News readers to know?

A. By using new and existing resources, and collaborating with various partners and stakeholders at the national, state and local levels, QIN-QIOs are in a unique position to make a positive impact on improving the cardiovascular health of all individuals throughout the United States.