Patient Utilization of Remote Patient Monitoring in a Pilot Implementation at a Federally Qualified Health Center

Area of Science:

• Digital Health
• Health Equity
• Implementation Science

Background:

• Remote patient monitoring (RPM) is crucial for managing hypertension.
• Understanding the impact of social determinants of health (SDOH) on RPM is vital for equitable care.
• Federally Qualified Health Centers (FQHCs) serve diverse populations, making them key sites for studying digital health equity.

Purpose of the Study:

• To investigate how demographics and SDOH affect RPM utilization and blood pressure (BP) improvement in hypertensive patients.
• To evaluate RPM effectiveness within the context of the Digital Health Equity-focused Implementation Research (DH-EquIR) framework.
• To identify factors influencing consistent RPM use and BP outcomes in an FQHC setting.

Main Methods:

• Secondary analysis of an RPM program for hypertension in FQHCs.
• Utilized linear mixed-effect models to assess the influence of demographics and Area Deprivation Index (ADI) on RPM utilization and BP changes.
• Included patients with three months of home BP monitoring data, measuring utilization by missed monitoring days.

Main Results:

• 105 participants (avg. age 55.4, 64.8% Black, 33.4% Hispanic/Latino) with a mean ADI NY state rank of 3.3.
• Increased missed RPM days correlated with higher ADI (0.24 days/week per ADI point, p < 0.05).
• Systolic BP decreased by 0.55 mmHg per week on RPM (p < 0.0001), irrespective of ADI.

Conclusions:

• This DH-EquIR-guided study in FQHCs shows minimal demographic or SDOH impact on RPM utilization.
• Participants demonstrated effective RPM use and achieved significant BP improvements, even in high-deprivation areas.
• RPM is a viable tool for hypertension management and BP control in diverse, underserved populations.