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Closing Hypertension Equity Gaps Through Digitally Inclusive Remote Patient Monitoring.

Antoinette Schoenthaler1,2,3, Radeyah Hack4,5, Soumik Mandal6

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Summary
This summary is machine-generated.

A digitally inclusive remote patient monitoring (RPM) model significantly reduced blood pressure (BP) in adults with hypertension (HTN). This approach addresses digital barriers, improving HTN control for marginalized populations.

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Area of Science:

  • Cardiovascular Medicine
  • Health Informatics
  • Public Health

Background:

  • Remote patient monitoring (RPM) effectively manages hypertension (HTN) but faces suboptimal adoption, especially in marginalized groups due to digital inclusivity barriers.
  • Lack of digital inclusivity (affordability, access, literacy) hinders equitable RPM adoption for hypertension control.
  • Federally Qualified Health Centers (FQHCs) serve diverse populations, making them ideal settings for testing inclusive RPM models.

Purpose of the Study:

  • To describe and evaluate a digitally inclusive RPM model for hypertension management within an FQHC setting.
  • To assess the impact of this model on blood pressure (BP) control among patients with uncontrolled HTN.
  • To identify and address digital and social barriers to care for marginalized populations.

Main Methods:

  • Implementation of a digitally inclusive RPM model using Target: BP protocols, team-based care, and electronic health record decision support.
  • Provision of free home BP monitors, training, language-concordant health coaching, and virtual high-risk clinic (VHRC) consultations.
  • Involvement of community health workers (CHWs) to mitigate digital and social needs barriers.

Main Results:

  • A cohort of 429 patients enrolled in RPM and VHRC over two years showed an average BP reduction of -13.5/-8.0 mmHg.
  • Compared to non-enrolled patients, the RPM group experienced significantly greater BP reduction (-13.5/-8.0 mmHg vs. -0.5/+0.6 mmHg).
  • Overall BP control increased from 68.44% to 82.99% across practices by the end of the study period.

Conclusions:

  • A digitally inclusive RPM model, integrated within an FQHC, demonstrates significant success in improving hypertension control.
  • Addressing digital inclusivity and social needs is crucial for equitable RPM adoption and effective hypertension management.
  • Policy-level changes are necessary to overcome persistent digital inequity barriers and ensure widespread access to effective RPM interventions.