Evaluation of an Email Blood Pressure Measurement Outreach Program

Area of Science:

• Cardiovascular Health
• Health Informatics
• Health Services Research

Background:

• Hypertension management often lacks adequate follow-up for patients with uncontrolled blood pressure.
• A mixed-methods evaluation was conducted on a healthcare system's email and secure message outreach program to enhance blood pressure (BP) follow-up.

Purpose of the Study:

• To evaluate the effectiveness of a digital outreach program in improving BP follow-up rates.
• To identify patient characteristics associated with program reach and BP measurement types (home vs. clinic).
• To understand patient experiences and identify areas for improvement in BP outreach.

Main Methods:

• A cohort of patients with hypertension and uncontrolled BP received secure messages prompting for home BP measurement (HBPM) or clinic BP checks.
• Program reach was assessed by BP recording in the electronic health record (EHR) within 3 months.
• Qualitative data from 22 patient interviews and Rapid Group Analysis explored patient experiences.

Main Results:

• Over half (53.8%) of contacted patients had a BP recorded in the EHR within 3 months.
• Follow-up rates were lower among younger, male, Asian, Black, and Hispanic patients.
• Home BP measurements were less common (18.9%) than clinic-based ones (81.1%), with Black patients showing the lowest HBPM use (9.9%). Home BP readings were more likely to be below 140/90 mmHg.

Conclusions:

• The outreach program successfully increased follow-up BP recordings for over half of patients.
• Significant disparities exist in home BP monitoring use, particularly among minority groups.
• Patient interviews indicated a need for improved patient education on BP measurement, targets, and feedback mechanisms.