The EvidenceNOW initiative, one of AHRQ’s solutions for revitalizing the Nation’s primary care system, uses a model of external support to help primary care practices implement the latest evidence into practice and improve their capacity for quality improvement. The EvidenceNOW model uses external practice coaches or facilitators and other external supports to help small and medium-sized practices optimize workflows, effectively use electronic health records, and manage other tasks essential to improving quality of care and patient outcomes. In recent decades, primary care practices have been hampered by fragmentation of the healthcare system, a lack of resources to meet patient needs, and limited access to an infrastructure to support quality improvement (QI). AHRQ developed EvidenceNOW to help them meet these challenges.
EvidenceNOW: Advancing Heart Health
EvidenceNOW: Advancing Heart Health, launched in 2015, was a $112 million effort and one of AHRQ’s largest primary care research projects to date. The project’s four goals were to:
- Help practices implement evidence to improve healthcare with a focus on heart health.
- Build primary care practice capacity to receive and incorporate evidence in the future.
- Learn how external quality improvement support helps primary care practices improve the way they work and improve the health of their patients.
- Build and disseminate a model of how to improve primary care with external supports.
To accomplish this work, AHRQ awarded grants to seven regional cooperatives. The cooperatives provided support to primary care practices to help them integrate evidence-based approaches into patient care and to offer services, such as onsite practice facilitation and coaching and health information technology support, to help practices improve delivery of heart health care. Together they worked with more than 5,000 clinicians at more than 1,500 practices that serve about 8 million patients. AHRQ awarded an eighth grant for an independent national evaluation of EvidenceNOW: Advancing Heart Health.
EvidenceNOW: Managing Unhealthy Alcohol Use
AHRQ's initiative to reduce unhealthy alcohol use was launched in October 2019, when the Agency awarded 3-year grants to six institutions across the country. The purpose of the program is to disseminate and implement into primary care practices evidence-based approaches to improve the use of screening for unhealthy alcohol use, brief intervention for those at risk, and medication therapy for alcohol use disorder.
Together, the six grantees are expected to work with more than 700 primary care practices. Grantees will receive support from AHRQ through a resource center and participation in a learning community. Grantees will evaluate their dissemination and implementation efforts, and an external evaluator will conduct a cross-grantee evaluation.
EvidenceNOW: Building State Capacity
This new initiative is investing $18 million over 3 years to four grantees to improve heart health and help reduce cardiovascular disease disparities by engaging with primary care practices and disseminating and implementing patient-centered outcomes research (PCOR) findings to improve care delivery. The initiative aims to address health equity in primary care by working with healthcare organizations, public health, and primary care practices in States with the highest rates of preventable cardiovascular disease events.
Four state-based teams will form cooperatives by aligning clinical, public health, and community interventions and working with State partners who collectively have the resources, skills, and commitment to support primary care practice improvement. They will build statewide networks of primary care practices and provide selected practices with the QI services they need to improve heart health. Initial work will focus on improving the management of blood pressure and decreasing tobacco use. The goal is to catalyze the development of a sustainable, State-based external primary care QI support infrastructure, using the EvidenceNOW model of external support.
EvidenceNOW: Managing Urinary Incontinence in Women
This initiative is planned for launch in 2021. The purpose of this initiative is to disseminate and implement the latest PCOR evidence on nonsurgical treatments for urinary incontinence in women in primary care practices. At its core it will use the EvidenceNOW model of primary care practice improvement support. The initiative will also focus on increasing integration between primary care and specialty care practices and aligning improvement strategies with community-based organizations and health systems.