Journal for healthcare quality : official publication of the National Association for Healthcare Quality · 2026
Population Health Approach to Blood Pressure Control Using Advanced Practice Provider-Managed Remote Patient Monitoring.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Pikel Karly, Burger Kristin, Menon Shreyas, Sassower Alexis, Eimer Micah J, Ulstrup Karin, Persell Stephen D, Paparello James, Tuchman Emily
Аннотация
BACKGROUND: Guidelines suggest that home blood pressure (BP) readings are more reliable than in-clinic measurements; however, quality metrics for patients with hypertension (HTN) primarily rely on in-clinic readings. To improve BP documentation and management, we implemented an advanced practice provider (APP)-managed remote patient monitoring (RPM) program.
METHODS: The electronic health records (EHR) of internal medicine patients with HTN and uncontrolled BP (≥140/90 mm Hg, per our institution's quality metric) were reviewed for more recent controlled (<140/90 mm Hg) home readings. If found, these values were imported into the chart's patient-reported vitals section. If not, patients were offered RPM. Participants (n = 472) received a BP monitor that automatically transmitted home readings to the EHR and had APP-led follow-up to guide lifestyle and medication adjustments until target BP was achieved. Lower targets (<130/80 mm Hg) were pursued for higher risk patients.
RESULTS: For 12 months, average systolic and diastolic BP of patients with initially uncontrolled HTN improved from 149.8 to 131.3 mm Hg and from 84.0 to 79.3 mm Hg, respectively ( p < .001). The percentage of patients with HTN and last documented BP < 140/90 mm Hg increased 7.94% compared with 1.75% at a comparison clinic providing standard care ( p = .022).
CONCLUSIONS: This APP-managed RPM program significantly improved BP outcomes and institutional quality metrics.
METHODS: The electronic health records (EHR) of internal medicine patients with HTN and uncontrolled BP (≥140/90 mm Hg, per our institution's quality metric) were reviewed for more recent controlled (<140/90 mm Hg) home readings. If found, these values were imported into the chart's patient-reported vitals section. If not, patients were offered RPM. Participants (n = 472) received a BP monitor that automatically transmitted home readings to the EHR and had APP-led follow-up to guide lifestyle and medication adjustments until target BP was achieved. Lower targets (<130/80 mm Hg) were pursued for higher risk patients.
RESULTS: For 12 months, average systolic and diastolic BP of patients with initially uncontrolled HTN improved from 149.8 to 131.3 mm Hg and from 84.0 to 79.3 mm Hg, respectively ( p < .001). The percentage of patients with HTN and last documented BP < 140/90 mm Hg increased 7.94% compared with 1.75% at a comparison clinic providing standard care ( p = .022).
CONCLUSIONS: This APP-managed RPM program significantly improved BP outcomes and institutional quality metrics.