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A collaboration among Ohio’s seven medical schools aims to keep the state’s health care providers up to date on best practices for preventing and treating cardiovascular disease. In the coming year, a team at 51����’s Heritage College of Osteopathic Medicine will be working to better share the project’s expertise with clinicians throughout southeastern Ohio.

“What we’ve been charged with for this next year is regional dissemination,” said Elizabeth Beverly, Ph.D., Heritage College associate professor of family medicine. “So each school is going to do their own regional efforts to disseminate things that we’ve been doing the past two years and also do some research.”

Beverly, who holds the Heritage Faculty Endowed Fellowship in Behavioral Diabetes, Osteopathic Heritage Foundation Ralph S. Licklider, D.O., Research Endowment, is principal investigator for the college’s role in the . This project, dubbed Cardi-OH, was launched in 2017 by the Ohio Department of Medicaid and the Ohio Colleges of Medicine Government Resource Center, working with Case Western Reserve University.

“We teach our students that in today’s medicine, the best quality care is provided by an interprofessional team working in close collaboration,” said Ken Johnson, D.O., chief medical affairs officer at 51���� and executive dean of the Heritage College. “The Cardi-OH collaborative applies that teamwork principal on a broader scale, to improve the lives of Ohioans at risk from heart disease and stroke, and I’m excited to see the contributions we’re making as a college to this valuable project.”

Heather Reed Robinson, associate director of the Ohio Colleges of Medicine Government Resource Center, said the Ohio Department of Medicaid funds the project through the Medicaid Technical Assistance and Policy Program (MEDTAPP) at about $2 million annually, with matching funds from participating schools bringing the budget to about $4 million. For the 2019-20 budget year, federal MEDTAPP funding to the Heritage College Cardi-OH team is about $161,000.

Teamwork aims at improving Medicaid health outcomes

The collaborative’s goal is to pool and share knowledge on treatment and prevention of cardiovascular disease, including heart disease and stroke, to improve health outcomes of people enrolled in the Medicaid program and eliminate health disparities. In 2017 heart disease was , and it disproportionately affects people who are Black or African-American.

Experts from the medical colleges identify and develop the most current evidence-based best practices to include in a standardized toolkit for physicians and allied health professionals. The information is shared among teams from each medical college and pushed out to care providers serving Medicaid patients throughout the state, through trainings, conferences, teleconferences, webinars and more. The group is also compiling an online repository of resources to share among the Cardi-OH partners and beyond.

Cardi-OH team members at the Heritage College include Beverly; Johnson; Darlene Berryman, Ph.D., R.D., L.D., associate dean for research and innovation; Karie Cook, R.N., B.S.N., director of operations with the Diabetes Institute; Stacy Wright, R.N., M.S.N., outcomes and resources manager with the Diabetes Institute; Tracy Shaub, D.O. (’92), associate professor and chair of the Department of Family Medicine; Melissa Standley, senior director of operations with the Office of Research and Grants; Jody Van Bibber, administrative specialist with the Diabetes Institute; Sarah Adkins, Pharm.D., associate director with the Diabetes Institute; Rosellen Roche, M.D., Ph.D., associate professor of family medicine; and Sebastian Diaz, Ph.D., J.D., research lead with the Central Appalachian Consortium of Colleges of Osteopathic Medicine.

Getting the word out through multiple channels

One example of Cardi-OH’s work to date is a campaign to educate Medicaid providers on the best way to measure blood pressure, a basic diagnostic procedure that’s often done incorrectly. Locally, the Heritage College team has provided training on this topic to the OhioHealth Physician Group Heritage College Primary Care & Residency Clinic in Athens. That effort was facilitated by Marc Richards, D.O. (’16), a resident at the clinic.

One innovative channel for sharing information is called “Project ECHO®,” which is a guided case-based learning model that leverages technology to allow Medicaid medical practices around the state to take part in case study discussions with experts and medical specialists through teleconferencing.

“You take a rural practice, for example, that doesn’t have a specialist, and you have a group of specialists for whatever is needed, who will go over a case with the primary care physician or whoever the provider is,” Beverly explained. “They review the case, tell you the treatment, and then you just discuss it.”

Heading into the third year of Cardi-OH, the Heritage College team has ambitious plans in the region, which includes Athens, Hocking, Meigs, Morgan, Perry, Vinton and Washington counties. These include a project to identify social determinants of health that act as barriers to managing hypertension in southeastern Appalachian Ohio, a campaign to educate local primary care providers on the use of new diabetes drugs that have cardiovascular benefits and the development of programming and materials on the psychosocial aspects of managing cardiovascular disease in rural Appalachia.

Ultimately, Beverly believes, Medicaid providers from all around the state can benefit from learning how their colleagues in other parts of Ohio deal with regional barriers to cardiovascular disease care.

“The idea was, let’s put our best minds together, let’s look at all the evidence, let’s go through this information, but let’s look at it not just in terms of guidelines, but in terms of social determinants of health,” she said. “Let’s look at it in terms of some of the inequalities that we see and the health disparities.”

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Note: The Ohio Cardiovascular Health Collaborative (Cardi-OH) is funded by the Ohio Department of Medicaid and administered by the Ohio Colleges of Medicine Government Resource Center. The views expressed in this article are solely those of the authors and do not represent the views of the state of Ohio or federal Medicaid programs.