UMMS Affiliation

Department of Medicine, Division of Preventive And Behavioral Medicine

Publication Date


Document Type



Cardiovascular Diseases | Community Health and Preventive Medicine | Health Services Administration | Health Services Research | Preventive Medicine | Race and Ethnicity | Telemedicine | Therapeutics


INTRODUCTION: Massachusetts developed and used bidirectional electronic referrals to connect clinical patients across the state to interventions run by community organizations. The objective of our study was to determine whether the use of Massachusetts's electronic referral system (MA e-Referral) reached racial/ethnic groups experiencing health disparities and whether it was associated with improved health outcomes.

METHODS: We assembled encounter-level medical records from September 2013 through June 2017 for patients at Massachusetts clinics funded by the Clinical Community Partnerships for Prevention into 2 cohorts. First, all patients meeting program eligibility guidelines for an e-Referral (N = 21,701) were examined to assess the distribution of e-Referrals among populations facing health disparities; second, a subset of 3,817 people with hypertension were analyzed to detect changes in blood pressure after e-Referral to an evidence-based community intervention.

RESULTS: Non-Hispanic black (OR, 1.4; 95% confidence interval [CI], 1.2-1.6) and Hispanic patients (OR, 1.3; 95% CI, 1.1-1.4) had higher odds than non-Hispanic white patients of being referred electronically. Patients completing their hypertension intervention had 74% (95% CI, 1.2-2.5) higher odds of having an in-control blood pressure reading than patients who were not electronically referred.

CONCLUSION: Clinical to community linkage to interventions through MA e-Referral reached non-Hispanic black, Hispanic, and Spanish-speaking populations and was associated with improved blood pressure control.


Masssachusetts, blood pressure control, health disparities, electronic referrals, community organizations

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DOI of Published Version



Prev Chronic Dis. 2019 Aug 22;16:E114. doi: 10.5888/pcd16.180583. Link to article on publisher's site

Journal/Book/Conference Title

Preventing chronic disease

Related Resources

Link to Article in PubMed

PubMed ID