Success Story: Hypertension Control Innovation in Rural Settings

Norton Sound Health Corporation (NSHC) (2022)

Norton Sound Health Corporation (NSHC) is a 2022 Hypertension Control Champion. A tribally owned and operated health care organization, NSHC receives funding from the Health Resources & Services Administration, the Indian Health Service, and other sources to serve more than 11,000 patients across 16 communities in Alaska’s Bering Strait region.

NSHC’s patient population is majority Alaska Native (Inupiat, Yup’ik, and Siberian Yup’ik). Nearly half of these patients are enrolled in Medicaid; almost another quarter have no health insurance.

NSHC’s innovative measures and emphasis on patient-centered care and relationships enabled it to achieve hypertension control in 80% of its patients with high blood pressure.

Meeting Patients Where They Are

NSHC serves a unique population, with patients who often have very low incomes, live in remote areas, and have limited access to healthy foods and the internet. To address these potential barriers, NSHC has structured its health care system around the patients.

Many of NSHC’s patients live hundreds of miles from the organization’s main clinic in Nome, Alaska, in communities that can be reached only by small airplanes. To reduce patient expenses and increase access, NSHC’s physicians fly to these villages instead of requiring patients to travel to them for care. Over a weeklong visit to a village, clinicians can check in with patients and get insight into their daily lives. For example, a visiting physician can make healthy eating recommendations based on what is available at the local grocery store.

Patients also receive support from community workers and a care team of dietitians, tobacco cessation counselors, and health educators who use produce markets and other activities to promote a heart-healthy lifestyle and chronic disease prevention.

Breaking Down Technical Barriers

If, during a clinic visit, the NSHC staff determine that a patient would benefit from a home blood pressure monitor, the patient receives one that same day. Staff ensure that the monitor does not leave the clinic in the box; instead, they put it together and help the patient practice using it.

Many patients have insufficient mobile data plans or lack the wireless connectivity needed to use standard blood pressure monitors that rely on Bluetooth. In those cases, NSHC encourages patients to keep a written log, send a text message, or bring the monitor to their next appointment so that staff can view the recorded history. The health care team can then collect these manual data to note recent trends and discuss measurements with the patients.

NSHC has a core focus on what is relevant and important to the patient, and staff work to connect those values to the importance of blood pressure control. For example, staff may emphasize how living a heart-healthy lifestyle could allow patients to continue activities like hunting, fishing, and caring for the community and family.

NSHC advises other rural practices looking to improve blood pressure control to listen to patients and staff before making any decisions. The barriers patients discuss may be both surprising and easy to address.

Million Hearts® appreciates and applauds Norton Sound Health Corporation for its dedication to caring for patients in remote areas and its perseverance in working toward our shared goal of preventing heart attacks and strokes by controlling blood pressure.

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