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Iowa Stakeholders Develop and Launch a Million Hearts® Action Plan
State: Iowa Submitted Date: 2015
Problem Statement
  • Heart disease and stroke are major causes of disability and death in Iowa.  
  • Agencies and organizations in the state saw the need for action to prevent these conditions and joined the national Million Hearts® initiative.
  • Because these groups were working mostly independently, there was duplication of effort and a lack of coordination around reaching Million Hearts® objectives.
  • Key stakeholders saw the benefit of bringing people together to organize activities by creating an Iowa Million Hearts® plan of action.
Program Action
  • The Iowa Department of Public Health IDPH, with assistance from key partners, was awarded technical assistance support from the National Association of Chronic Disease Directors to organize a stakeholder meeting as a first step in creating an Iowa Million Hearts® Action Plan.
  • The day-long Million Hearts® Stakeholders Workshop helped the 25 attendees increase their understanding of the Million Hearts® Initiative and discuss potential action steps for reaching the public, healthcare providers and health systems.
  • A work group formed and met regularly following the Workshop to develop the Iowa Million Hearts® Action Plan, a set of goals and objectives to implement through June 2017 when the national initiative ends.
  • The key partners continue to meet to monitor progress on the plan’s objectives and to develop new objectives and strategies as needed.
Data/Other Information Collected

A group of key partners (American College of Cardiologists (ACC)-Iowa Chapter, American Heart Association (AHA)-Midwest Affiliate, Iowa Department of Public Health (IDPH), Iowa Healthcare Collaborative (IHC), and Telligen) had been promoting awareness of the Million Hearts® Initiative since its inception in late 2011.

Initially, the key partners worked to spread awareness of Million Hearts® through programmatic newsletters, presentations, health fairs, provider conferences, etc. Individual, provider and organizational pledges to the Initiative were encouraged. Once the national initiative became more defined, work concentrated more around publicizing the ABCS--Aspirin Use when Appropriate, Blood Pressure Control, Cholesterol Management and Smoking Cessation. Work switched to emphasizing evidence-based strategies that could, when successfully implemented by healthcare providers, move the needle towards fewer deaths. Since the beginning, the national Initiative has concentrated most of its recommendations  and resources around blood pressure control: increased use of electronic health records (EHRs) and Registries that would lead to population health analysis within clinics or health systems;  team care/care coordination models with an emphasis on providers working collaboratively with pharmacists to control high blood pressure; the advancement of a specific protocol in each health system or practice to be utilized by the care team when a diagnosis of high blood pressure is made; utilization of patient self-measured blood pressure (SMBP) with clinical support and monitoring; and resources developed and aligned with each of these topics which are available on the national Million Hearts® website.

Million Hearts® Stakeholders Workshop participants included staff from the key partner organizations along with stakeholders representing other organizations, such as the YMCA, individual Iowa health systems, local public health and healthcare organizations, educational institutions, pharmacists, the Iowa Pharmacy Association, and the Iowa Medical Society. The key partner group has steadily grown to incorporate Iowa Medicaid Enterprise (IME), The University of Iowa (U of I), The VA Central Iowa Health System(VA-CI), Iowa Pharmacy Association (IPA), Iowa Primary Care Association (IPCA) and the YMCAs in their Greater Des Moines Association. The Iowa Million Hearts® Action Plan was finalized at the end of 2014 and was formally published in February, 2015.

The stakeholder group initiated the plan in early 2015 and will meet once a year to pool success stories and data related to the specific objectives under each of these nine Plan goals:

Goal 1: Increase Public Awareness of the Million Hearts® Initiative and the ABCS
Goal 2: Increase Healthcare System Awareness of Million Hearts Initiative and the ABCS
Goal 3: Increase Implementation of Team Care/Care Coordination in Primary Practice to Address Hypertension
Goal 4: Increase Implementation of Provider-Pharmacist Teams to Address Hypertension
Goal 5: Increase Implementation of Hypertension Protocols in the Primary Care Setting
Goal 6: Increase Utilization of Patient Self-Measured Blood Pressure (SMBP with Clinical Monitoring
Goal 7: Increase Health System Awareness of, and Referral to, Available Community Resources for Lifestyle Improvement Education
Goal 8: Increase and Enhance Health Information Technology (EHR/Registry Use) in Managing Patients with Hypertension
Goal 9: Decrease Disparities in Hypertension Care and Control

 A copy of the plan document is available at:

Impact / Accomplishment

The Million Hearts® Workshop resulted in:

  • Increased Iowa partner contributions to reaching the goals of an important national initiative
  • Participation of private and non-federally-funded partners in work to improve public health
  • Creation of a plan for statewide, coordinated action to reach specific goals/objectives related to heart disease and stroke
Challenges/Lessons Learned

It can be difficult to manage a plan with multiple diverse partners since each partner has their own idea of what the desired outcomes. From the beginning, the Iowa partners agreed that it was desireable to have a state plan that accommodated participation by many diverse partners who could integrate them into existing health care and community infrastructures. IDPH was seen as the organization that could serve as the main organizer for activities such as convening meetings, pulling together all contributions and formatting the action plan.

Next Steps

The partners received a copy of the finished plan. IDPH has taken on the task of sending out Million Hearts® updates to partners on a regular basis. The partners have agreed to come together annually to monitor and celebrate progress on the plan.

Terry Y. Meek, Health Systems Coordinator
Iowa Department of Public Health