Abstract

Introduction: Traditional methods for diagnosing and treating HTN, which is the most common modifiable risk factor accounting for ASCVD in the US, have been ineffective. Innovative solutions, like remote patient monitoring (RPM), can transform how we provide longitudinal care for patients with HTN. Hypothesis: An advanced practice provider led HTN program, which leverages RPM and technology-enabled treatment protocols, can provide a scalable solution for optimizing HTN management nationwide. Methods: Cadence is a healthcare technology organization that enrolled patients into a virtual HTN program in PCP clinics in 11 states across the US from February 2022 to April 2023. Eligible patients were Medicare enrollees who had a diagnosis of HTN based on ICD-10 codes, mean blood pressure (BP) >140/90 (using last 3 EMR-based vitals) and were enrolled for at least 30 days. Using daily vitals from a cellular enabled BP cuff and scheduled visits, a team of multidisciplinary clinicians leveraged technology-enabled clinical protocols to facilitate optimization of HTN control. A two-sample t-test was used to detect a difference in mean BP. Results: A total of 4006 patients were enrolled (mean age 73 +/- 9, 70% White) with a baseline BP of 144/83 mmHg. The total reduction in systolic BP (SBP)/diastolic BP (DBP) was 9/6 (p<0.001) in the last week compared to the first week (mean follow-up of 136 +/- 92 days). The total number of vitals recorded, clinical visits and phone calls completed, and high acuity clinical alerts resolved is depicted in Figure 1A. The SBP/DBP reductions by different BP strata are depicted in Figure 1B. There was a ~2x increase in the number patients at goal (BP<130/80) in the last week compared to the first week (31% vs. 15%; p<0.001). Conclusions: A remote patient monitoring HTN program not only can improve the diagnosis of hypertension, but also can significantly reduce blood pressure, and in doing so help more patients achieve guideline recommended BP goals.

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