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An opportunity for practices to take part in a home blood pressure monitoring pilot

21st February 2019

Warrington_Digital_Hypertension_landing_page.pngUsing digital technology to support improvements in high blood pressure diagnosis in general practice

An opportunity for practices to take part in a home blood pressure monitoring pilot

Background

Using funding from the Innovation Agency, Warrington Public Health team have recently developed and implemented a digital hypertension pilot project. Working with a small number of practices, the project involves the use of innovative digital technology that connects patients self-monitoring data to GP systems in real-time.

This home BP monitoring project supports the NICE guidance that seeks to improve the diagnosis and management of high BP through home monitoring, self-management and lifestyle modification.

Technology

The technology, in the form of a digital monitor and accompanying mobile phone app, collects, stores and securely transmits relevant data to clinical systems. Through the use of alerts to their mobile phones, patients are supported to monitor and control their BP. The technology reviews patient history and writes back clinical measurements to GP systems. The tool and pathway also provides support for staff through a medication optimization function.

Although the Warrington pilot has focussed on hypertension, the technology has potential application in other long-term conditions; to support patient conformance with evidence-based pathways and generate efficiencies for practices.

Outcomes and benefits

Considerable development work has been undertaken as part of the Warrington pilot, including the development of an agreed hypertension diagnostic pathway, clinical templates and GP system searches. Patient information documentation and consent forms, Privacy Impact Assessments and data sharing agreements, as well as self-care guidance for patients to make lifestyle changes have also been produced. A comprehensive evaluation framework has also been developed. These products are all transferrable to other areas.

Case studies and qualitative insight gathered to date in Warrington illustrate the potential of the technology, and the benefits to both patients and Practice, including:

  • Effectiveness: The system of alerts and reminders support patient compliance
  • Safety: Patients with significantly raised readings detected early facilitating timely intervention
  • Efficiencies:
    • Saved appointments for Practices whose existing protocols involve repeat appointments to review, issue monitors, schedule blood tests etc.
    • Feedback of automated average readings to clinical systems ensuring efficient and robust recording of BP measurements.
    • The system of alerts to patients saves staff admin time following up and prompting patients.
    • Engagement: The tool ensures patients with busy lives can use at their convenience, with the potential to identify high blood pressure at an early stage in younger cohorts.
      • Decision-making: The medicines optimisation element has yet to be fully tested with Warrington patients over the full 6-week pathway, however local clinicians trained in its use feel it will be extremely useful in supporting decision-making and compliance with guidance that advises drug treatment should be tailored to the individual, taking into account CVD risk, co-morbidity, adverse effects of medication and patient preference.

Opportunity

To fully evaluate the impact and effectiveness, more patients need to be enrolled to use the technology. There is therefore an opportunity to extend the pilot to further practices across Cheshire and Merseyside, with potential funding sources available. This technology would effectively support practices who are keen to improve the quality and consistency of hypertension diagnosis, and subsequent management and provision of lifestyle advice. Awareness-raising work to detect undiagnosed hypertensives would be needed alongside this technology to ensure an adequate flow of patients.

Ask

If you are keen to improve the diagnosis and management of hypertension and would like to know more about the pilot and the technology, please contact: tflute@warrington.gov.uk Public Health, Warrington or Steven.Bauer@dxs-systems.co.uk DXS International.

 

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