Well over 300,000 Native Americans in Oklahoma live on tribally-owned land, with many in primarily rural areas, according to U.S. Census Bureau data. Native Americans also have some of the highest rates of heart disease since they are less likely to seek medical care at the early stages of illness.
The state’s Quality Improvement Organization (QIO), the Oklahoma Foundation for Medical Quality (OFMQ), reached out to the Oklahoma City Area Inter-Tribal Health Board several years ago to help improve Native American cardiovascular health. Through the QIO’s Cardiac Learning and Action Network (LAN) initiative and other outreach events, the two organizations have helped spread the importance of heart health and the fundamentals of the Million Hearts™ campaign.
OFMQ has developed several other partnerships to cast a wide net and reach as many people as possible. OFMQ also leveraged the partners developed through the contract it holds for the Oklahoma’s Regional Extension Center (REC); they regularly collaborate on prevention, cardiovascular health issues and the Million Hearts™ campaign. The QIO also has long-term relationships with Native American hospitals, primarily through Medicaid reporting.
“It’s all about relationships,” said Tracy Prather, OFMQ’s Ambulatory Practice Specialist. “You have to work with folks you know can bring about those relationships, opportunities and introductions.”
Prather and his colleague Elanor Wallis – the Care Transitions, Health Care-Acquired Infection (HAI) and Ambulatory Project Manager at OFMQ – hit the ground running, working with local health providers, media, non‑profits, government health organizations, the REC, tribal leaders and corporate entities to push through the Million Hearts™ campaign message.
When the campaign first launched, Oklahoma ranked 47th nationwide in Million Hearts™ pledges. Within just nine months, Oklahoma’s pledge ranking jumped to second place.
For OFMQ, it is about more than just the message. There’s on-the-ground action to back up that message. QIO staff members visit Native American clinic sites regularly to help standardize their electronic health records (EHRs) and gather data on blood pressure, aspirin therapy, smoking cessation and more. Additionally, monthly calls are held to discuss various policies and procedures to ensure that everyone is on the same page.
By conducting site visits, OFMQ helps the clinics identify best practices and areas of improvement to promote sustainability. The QIO has identified previously undiscovered discrepancies, made improvements and shared data through the Cardiac LAN.
OFMQ is currently focused on sustainability and ensuring that Native Americans can use their own resources. The QIO continues to develop new partnerships and maintain its current ones for a broader and richer knowledge base, and communication avenues.
Moving forward, the QIO is working with the REC on reaching out to Oklahoma primary and specialty care physicians that have EHRs. Since the REC provides regular group learning opportunities for both providers and patients, OFMQ has been invited to discuss cardiac care and meaningful use.
“It takes time to build trust, but once you do, the relationships are deep and continuous,” Prather said. “We have never given up. We will continue to work with Native American clinics to improve cardiovascular health throughout Oklahoma.”