These Louisiana physicians can monitor your blood pressure—and you don’t even have to leave your living room

July 12, 2018

There were termites in the garage and a $2,100 bill to get rid of them. The mechanic had called to say he didn’t know when the car would be fixed. So after a summer day full of aggravations, 73-year-old Ann R. Ware wasn’t surprised to see the result when she sat down on her sofa, wrapped a blood pressure cuff around her arm and pressed a button on her iPhone screen to trigger the cuff to take a reading.

It was too high.

At 8:30 a.m. the next day, she got a call from someone worried about the result. It was Megan McKenzie, a clinical pharmacist at Ochsner Medical Center.

“Miss Megan, if she sees that my pressure is a little high, she calls immediately,” Ware said. “She wants to know: What’s wrong? Do I need to go to the doctor? Do I need to go to the E.R.?”

Ware told McKenzie about her stress but said she didn’t have any alarming symptoms.

For the first time in years, Ware’s blood pressure is near her goal, managed remotely in the months between appointments by a care team guided by the measurements she takes once or twice a week from the comfort of her living room. Her iPhone, which connects to the blood pressure cuff by wireless Bluetooth, automatically sends the data to her medical record and a care team of pharmacists and health coaches.

The approach could benefit more than 100 million Americans who are at increased risk of heart attacks and strokes because of high blood pressure. It could herald the disruption of medicine by gadgets that enable patients to collect, monitor and share their own data.

Yet the real barrier to widespread use of at-home blood pressure monitoring and other similar innovations for chronic diseases like diabetes and heart failure is not as much technological as human. Ware’s Bluetooth cuff is a modernized version of a century-old technology, and her iPhone is a hand-me-down from her grandson. It’s the support system around the cuff that is hard to replicate—Ware’s “Miss Megan,” the digital pipeline to make sure her data doesn’t sit unread on some server or overwhelm doctors, and the commitment by Ochsner to build consumer-friendly tech centers to help patients set up their gadgets.

Other programs around the country have tried to use technology to connect patients and their healthcare providers, but they are not yet widespread. That’s largely because they represent major shifts for healthcare systems that are still largely paid for patching people up, not preventing sickness. The current system excels at delivering acute care: Patients show up in doctor’s offices with illness or injuries, and doctors are paid for services rendered. But as healthcare spending has soared, driven by costly and often preventable chronic diseases, there’s a growing realization that the model is a poor fit for lifelong conditions that are shaped by what happens between office visits—whether it’s remembering to take their pills each day or sticking to a diet.

Ochsner, a nonprofit health- care delivery system in southeast Louisiana with 30 hospitals, is gambling that the healthcare system is finally ready for change. Technology is pervasive in people’s lives, insurers and government health plans are gradually shifting to pay for the quality instead of the quantity of healthcare people receive, and consumers are demanding convenience.

When Ochsner launched its digital hypertension program three years ago, the health system footed the bill for the blood pressure cuffs, the care team and the digital infrastructure. It was a risk. Research suggested the approach could achieve far better blood pressure management, but it wasn’t clear if in a real-world setting, patients would value the information, doctors would be open to using it and people would end up healthier.

Ochsner’s early evidence showed that within three months, more than two-thirds of those receiving the digital intervention had their blood pressure in control, compared with 31% in a group that got traditional care. Whether that will translate into saving lives, preventing strokes or saving money remains to be rigorously proven, but the health system has 2,500 patients in its digital hypertension program and has expanded its platform to other areas, including pregnancy and diabetes.

The Washington Post has the full story

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