Table 1.

Key Opportunities to Advance Public Health for Individuals With Congenital Heart Disease

Identify and Investigate
	Monitor
1	Initiate comprehensive population‐based monitoring of the incidence, prevalence, morbidity and mortality of congenital heart defects across the life span
	Investigate determinants and modifiers
2	Leverage existing data to examine epidemiological and clinical factors associated with better and worse health outcomes health service delivery

Develop Interventions and Policies
	Unite and align
3	Design universally accepted policies and interventions to improve access to appropriate care, including specialty care and services
	Reduce risk
4	Identify optimum timing of type of procedural medical intervention to inform treatment decisions in infancy, childhood, and adulthood
5	Research to identify strategies to reduce cardiac and noncardiac morbidity, including the brain, lungs, liver, and kidneys
6	Initiate practical, effective, and sustainable interventions for known modifiable risk factors for congenital heart disease that have public health importance (eg, maternal pregestational diabetes mellitus)
	Improve outcomes
7	Improve access to special education and/or other school‐based interventions for all children with congenital heart disease who have a neurodevelopmental impairment
8	Develop formal transition programs between pediatric and adult care and ongoing monitoring to assess the success or obstacles to transition efforts
9	Initiate programs to assure adequate support services for adults with neurocognitive decline
	Equal access
10	Encourage insurance availability for congenital heart disease care across the life span, including specialty care when necessary
11	Develop programs to assure that all people with congenital heart disease have primary care in a patient‐centered medical home that includes supports to family members and caregivers

Implement and Evaluate
	Prevention education
12	Target educational programs to individuals and the medical community to disseminate information about proven and effective strategies to prevent congenital heart disease
	Quality care
13	Project workforce necessary to care for the growing population of adults with congenital heart disease and adjust the number of fellowship training programs and positions accordingly
14	Optimize healthcare systems with adequate specialty care for cardiac and noncardiac conditions to address the needs of people with congenital heart disease
	Evaluation
15	Develop and track key quality measures related to care for congenital heart disease and congenital heart disease–related population health