Research Activities, October 2013
E-health blood pressure control program shows positive preliminary results
Health Information Technology
Only 35 percent of hypertensive patients have their condition adequately controlled. Health information technology (IT) can improve the quality of care for such patients by integrating home blood pressure monitor (HBPM) data through a Web portal with the electronic medical record and personal health record (PHR) that connects the patient virtually to the medical team. Models of care that integrate health IT may also cost less than standard models of care.
When researchers performed a preliminary feasibility test of an e-health blood pressure control system with a small group of patients, they found that, with patient navigator support, it was well received by patients, providers, and the health care team. Ninety percent of the enrolled patients were able to upload BP readings to the Web portal. Approximately half of the patients required technological support in order to use the e-health blood pressure control program. Some of the patients had their hypertension controlled with little interventional support, but some required significant assistance.
The study focused on 28 patients with uncontrolled hypertension who were given home blood pressure monitors. After a 90-day break-in period, they were divided into two groups. The first group used a "high-tech" solution consisting of access to only the HBPM-integrated PHR and the tailored Web portal in order to monitor BP progress, and the second group used a high-tech/high-touch solution that included support from a patient navigator (health coach) in addition to the high-tech component. The patient navigator is a community health worker or lay person who coaches patients to assume a more active role in their care. During the final 3 months of the study, all participants received patient navigator support. Overall, 65 percent of participants had their blood pressure controlled with the high-tech/high-touch approach compared to 45 percent with HBPM alone.
The researchers concluded that their study showed promising results of a high-tech/high-touch approach in advancing the meaningful use of technology in primary care. This study was supported by AHRQ (HS18238).
See "E-Health blood pressure control program," by David K. Ahern, Ph.D., Lynda J. Stinson, B.S., Lisa A Uebelacker, Ph.D., and Charles B. Eaton M.D., M.S., in the September/October 2012 Medical Practice Management, pp. 91-100.