{
  "release_id": "5dcd9b263fe17744",
  "id": "cardio:million-hearts-cardiac-rehab-change-package",
  "owner": "cardio",
  "kind": "resource",
  "slug": "million-hearts-cardiac-rehab-change-package",
  "name": "Million Hearts Cardiac Rehabilitation Change Package",
  "aliases": [
    "CRCP",
    "Cardiac Rehabilitation Change Package"
  ],
  "atlases": [
    "cardio"
  ],
  "summary_plain": "A toolkit from Million Hearts, developed with the rehabilitation association AACVPR, for hospital and cardiac rehabilitation teams that want more eligible patients to take part. It lists changes a team can make to its processes, ideas that can be tried, and tools to adapt. The 2023 second edition added ideas such as automatic opt-out referrals and hybrid delivery models. The page advises teams to test each chosen strategy on a small scale before wider use.",
  "summary_technical": "A pointer to a web page and PDF guide on the Million Hearts website (second edition, 2023; the first edition appeared in 2018). Its page-level reuse terms were not read, because the HHS web policies page returned HTTP 403 to a script, so this atlas restates facts in its own words and quotes nothing. The page and the guide carry ideas for change and supporting tools; none of them is restated here. This toolkit is a hospital resource and is not evidence that any strategy works.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-15",
  "last_evidence_check": "2026-10-15",
  "next_review_due": null,
  "identifiers": [],
  "navigation": {
    "cardio": {
      "system": [
        "heart"
      ],
      "condition-area": [
        "acute-care-and-long-term-living"
      ]
    }
  },
  "payload": {
    "resource_type": "tool",
    "owner": null,
    "contents": "Ideas for change and supporting tools for hospital and cardiac rehabilitation program teams that want to increase use of cardiac rehabilitation.",
    "access": "Free web page and PDF guide on the Million Hearts website: https://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.html",
    "license": "Reuse terms not read (the HHS web policies page returned HTTP 403). This atlas names and links the resource, states facts in its own words and does not quote it."
  },
  "content_digest": "d7254917a429bcb26e08ee86acf1436aeff252389d6c5990d4444cb2fa9d9638",
  "review": {
    "content_digest": "d7254917a429bcb26e08ee86acf1436aeff252389d6c5990d4444cb2fa9d9638",
    "current": [],
    "conflicting": [],
    "stale": [],
    "inactive": []
  },
  "claims": [
    {
      "release_id": "5dcd9b263fe17744",
      "id": "cardio:claim-million-hearts-crcp-partnership",
      "owner": "cardio",
      "subject_entity_id": "cardio:million-hearts-cardiac-rehab-change-package",
      "category": "descriptive",
      "statement": "The Million Hearts page on its Cardiac Rehabilitation Change Package says the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) was a partner in developing the package, and that it lists process improvements that cardiac rehabilitation teams can make to raise the use of cardiac rehabilitation.",
      "context": {
        "id": "cardio:ctx-million-hearts-us-initiative",
        "label": "US national heart attack and stroke prevention initiative (Million Hearts)",
        "recipient": "unknown",
        "population": "The United States population; the initiative also focuses on groups experiencing inequities.",
        "care_setting": "National public health initiative.",
        "geography": "United States",
        "life_stage_note": "Not stated in the source",
        "life_stage_terms": null,
        "gestational_age_min_days": null,
        "gestational_age_max_days": null,
        "gestational_age_basis": null,
        "postnatal_age_min_days": null,
        "postnatal_age_max_days": null,
        "gestational_age_status": null,
        "postnatal_age_status": null,
        "followup_description": "The current vision runs from January 2022 to December 2026.",
        "eligibility": {
          "inclusion": [],
          "exclusion": []
        }
      },
      "evidence_stage": "guidance",
      "certainty": "not_assessed",
      "certainty_method": null,
      "limitations": "This is the initiative's description of its own toolkit on a CDC-managed web page. It reports no results and is not evidence that any listed change works. The page's reuse terms were not read, so the page is cite-only and no wording from it is used here.",
      "editorial_state": "draft",
      "checked_at": "2026-10-15",
      "next_review_due": null,
      "valid_from": null,
      "valid_to": null,
      "citations": [
        {
          "evidence_role": "supports",
          "locator": "What Is the CRCP, para 1 (partnership)",
          "applicability_note": "The partnership and the purpose of the package.",
          "snapshot": {
            "id": "cardio:millionhearts-cardiac-change-package-2026-10-15",
            "retrieved_at": "2026-10-15T13:49:15Z",
            "content_hash": "501244e34fd804d9c585c06f2d6b689e9eae3e7f22c649ed5d3ab17f52ba6597",
            "source_effective_date": null,
            "public_archive_url": null,
            "source_state": "current"
          },
          "source": {
            "id": "cardio:millionhearts-cardiac-change-package",
            "source_type": "webpage",
            "title": "Cardiac Rehabilitation Change Package (Second Edition) (Million Hearts)",
            "canonical_url": "https://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.html",
            "identifiers": [],
            "publication_date": null,
            "publisher": "Centers for Disease Control and Prevention (Million Hearts)",
            "edition": "Page fetched 2026-10-15. The page carries the line Last Reviewed: February 21, 2024. It describes the second edition, published in 2023.",
            "reuse_basis": "millionhearts.hhs.gov is managed by the Centers for Disease Control and Prevention, but the HHS web policies page returned HTTP 403 to a script (fetched as cl-hhs-web-policies.html, not worked around), so the page-level reuse terms were not read and are unverified. Only the hash of the page is kept. Public text is cite_only until the integration owner confirms the terms.",
            "public_text": "cite_only"
          }
        }
      ],
      "review": {
        "content_digest": "22abaf308d6611f0d4dd099ef9f68602b7b7927f2e02b4e2db24113a01d96170",
        "current": [],
        "conflicting": [],
        "stale": [],
        "inactive": []
      },
      "api_path": "api/v1/claims/cardio--claim-million-hearts-crcp-partnership.json"
    }
  ],
  "decisions": [],
  "milestones": [],
  "relationships": {
    "outgoing": [
      {
        "predicate": "addresses",
        "label": "Hospital toolkit",
        "clinical_claim_not_fact": false,
        "family": "navigation",
        "other_entity_id": "cardio:bottleneck-low-cardiac-rehab-participation",
        "other_entity_in_atlas": true,
        "claim_id": null,
        "evidence": null,
        "primary": false,
        "role": null,
        "valid_from": null,
        "valid_to": null
      },
      {
        "predicate": "related_to",
        "label": "Developed in partnership with this association, according to the Million Hearts page",
        "clinical_claim_not_fact": false,
        "family": "navigation",
        "other_entity_id": "cardio:aacvpr",
        "other_entity_in_atlas": true,
        "claim_id": null,
        "evidence": null,
        "primary": false,
        "role": null,
        "valid_from": null,
        "valid_to": null
      }
    ],
    "incoming": [
      {
        "predicate": "related_to",
        "label": "Related to",
        "clinical_claim_not_fact": false,
        "family": "navigation",
        "other_entity_id": "cardio:million-hearts",
        "other_entity_in_atlas": true,
        "claim_id": null,
        "evidence": null,
        "primary": false,
        "role": null,
        "valid_from": null,
        "valid_to": null
      }
    ]
  },
  "page_path": "resources/million-hearts-cardiac-rehab-change-package/",
  "context_path": "api/v1/context/cardio--million-hearts-cardiac-rehab-change-package.md"
}
