Integrative Monitoring of Hypertension Care Using Routinely Collected Clinical Data in Mexico's Emerging Federalised Public Health Care Provider.

BACKGROUND: Health information systems are a cornerstone for assessing health system performance, particularly for leading conditions contributing to disease burden, such as hypertension, making effective monitoring indispensable. In October 2023, Mexico initiated the federalisation of public health services for the population without social security, creating an integrated national public health care provider and increasing the need for system-level monitoring tools capable of supporting longitudinal assessment across heterogeneous settings. OBJECTIVE: To describe the development and early application of an integrative monitoring platform using routinely collected clinical data to support system-level oversight of hypertension care within Mexico's federalised public health care provider. DESIGN: Descriptive health services research study based on secondary analysis of routinely collected clinical data. METHODS: An integrative monitoring platform was developed to organise data into a structured indicator framework covering four domains: care engagement and continuity; clinical care processes; intermediate clinical outcomes; and case-mix and clinical complexity. The platform enables longitudinal and subnational analyses across selected indicators presented as illustrative use cases. Institutional reach was assessed using an overall monitoring period from January 2024 to September 2025, while clinical process and intermediate outcome indicators, including blood pressure control, were calculated within a predefined active six-month monitoring cohort using the September 2025 reporting date. RESULTS: From January 2024 to September 2025, a total of 486,044 individuals received hypertension-related care within primary care services across participating states. The active six-month cohort included 322,661 individuals, with 67.2% (95% CI, 67.04-67.37) achieving blood pressure control (<140/90 mmHg), and 36.8% (95% CI, 36.62-36.96) achieving strict control (<130/80 mmHg). For those with sub-optimal control, 63% had timely clinical follow-up and 48% underwent treatment intensification. A high proportion of individuals presented high risk features including obesity (36.4%; 95%CI, 36.2-36.5), diabetes (48.7%; 95%CI, 48.5-48.8) or high cardiovascular risk characteristics (81.7%, 95%IC, 81.5-81.8). CONCLUSION: Transforming routinely collected clinical data into an integrative monitoring platform is feasible within a newly federalised public health care provider. Routine monitoring of relevant indicators across multiple dimensions of care provides a structured basis for system-level oversight, longitudinal assessment, data-informed decision-making, and continuous learning within large public service delivery systems.