Multisociety Jordan National Hypertension Registry (JNHR) Initiative

Multisociety Jordan National Hypertension Registry (JNHR) Initiative
National Implementation Plan and Operational Framework
A Collaborative Program of Nine Jordanian Medical Societies Coordinated by the Jordanian Cardiac Society (JCS)

Participating Societies
•⁠ ⁠Jordanian Cardiac Society (JCS)
•⁠ ⁠Jordan Atherosclerosis Society (JAS)
•⁠ ⁠Jordan Society of General Practitioners (JSGP)
•⁠ ⁠Jordan Society of Internal Medicine (JSIM)
•⁠ ⁠Jordan Society of Nephrology (JSN)
•⁠ ⁠Jordan Society of Family Medicine (JSFM)
•⁠ ⁠Jordan Emergency Medicine Society (JEMS)
•⁠ ⁠Jordan Endocrine and Diabetes Society (JEDS)
•⁠ ⁠Jordan Nutrition Society (JNS)

Registry Completion Model

The registry is designed to minimize physician workload and maximize feasibility in high-volume clinical settings.

Who Completes the Registry?

Primary data entry should be performed by a trained:

•⁠ ⁠Hypertension Registry Nurse
or
•⁠ ⁠Designated clinic data coordinator
or
•⁠ ⁠Trained medical assistant

The treating physician does not complete the full form.
The physician’s role is limited to:

•⁠ ⁠Confirming diagnosis
•⁠ ⁠Confirming treatment plan
•⁠ ⁠Validating data accuracy

This confirmation should take less than 30–60 seconds per patient.

Is Data Entry Manual or Automatic?

The system should be semi-automated:

Automatic Data Population (where electronic systems exist):

•⁠ ⁠Patient age and sex
•⁠ ⁠Laboratory results (eGFR, LDL, HbA1c, UACR)
•⁠ ⁠Blood pressure readings (if integrated devices are used)
•⁠ ⁠Medication list (if EHR-linked)

Manual Entry (Minimal Required Fields):

•⁠ ⁠Risk factor checkboxes
•⁠ ⁠Acute events
•⁠ ⁠Adherence
•⁠ ⁠Follow-up status

In high-volume primary care centers, the form should be limited to essential fields only.

The model allows expansion in university hospitals to include extended research variables.

National Implementation Plan – Three Phases

Year 1 – Pilot Phase

Objective: Demonstrate feasibility

•⁠ ⁠Select 3 major hospitals
•⁠ ⁠Select 5 primary healthcare centers
•⁠ ⁠Assign one Hypertension Registry Nurse at each site
•⁠ ⁠Use REDCap or secure cloud-based platform
•⁠ ⁠Provide short focused training (2–3 hours)
•⁠ ⁠Collect data from 1,000–2,000 patients
•⁠ ⁠Issue first national summary report

Key Outcome:
Feasibility confirmed and data completeness >80%

Year 2 – Expansion Phase

Objective: Structured scale-up

•⁠ ⁠Include private sector hospitals
•⁠ ⁠Link with central laboratories
•⁠ ⁠Implement partial automatic data extraction (BP and labs)
•⁠ ⁠Launch national dashboard for quality monitoring
•⁠ ⁠Submit first international scientific abstract

Key Outcome:
5,000–10,000 patients registered

Year 3 – National Integration Phase

Objective: Formal national adoption

•⁠ ⁠Sign Memorandum of Understanding with Ministry of Health
•⁠ ⁠Gradual integration with national electronic health records
•⁠ ⁠Introduce national quality indicators
•⁠ ⁠Compare performance across governorates
•⁠ ⁠Publish annual national hypertension report
•⁠ ⁠Initiate international research collaborations

Key Outcome:
Establishment of a National Hypertension Quality Index

Principles for Success

•⁠ ⁠Do not rely solely on physicians for data entry
•⁠ ⁠Keep data entry simple and time-efficient
•⁠ ⁠Implement semi-automatic data capture whenever possible
•⁠ ⁠Avoid collecting unnecessary variables
•⁠ ⁠Produce annual outcome reports demonstrating measurable benefit

Scalability

The registry can be expanded in university hospitals to include:

•⁠ ⁠Advanced imaging data
•⁠ ⁠Research biomarkers
•⁠ ⁠Longitudinal outcomes
•⁠ ⁠Linkage with cardiology registries

This model ensures:

•⁠ ⁠Practical implementation in busy Jordanian clinics
•⁠ ⁠Minimal burden on physicians
•⁠ ⁠High data quality
•⁠ ⁠International compatibility
•⁠ ⁠Sustainable long-term operation