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Designing a Usable Clinician Report for Home Blood Pressure Monitoring in Pregnancy: A Mixed Methods Study
Cassie Shao1, Katherine A Tak1, Ritika Revoori1
1Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA.
American Journal of Hypertension
|June 15, 2026
Summary
Home blood pressure monitoring (HBPM) reports can aid hypertensive disorders of pregnancy (HDP) management. However, workflow and integration challenges must be addressed for successful clinical adoption of these tools.
Area of Science:
- Obstetrics and Gynecology
- Cardiovascular Health in Pregnancy
- Digital Health Tools
Background:
- Hypertensive disorders of pregnancy (HDPs) are a major cause of maternal and fetal complications.
- Limited adoption of home blood pressure monitoring (HBPM) hinders effective perinatal hypertension management.
- Existing workflows and integration issues impede the use of HBPM in clinical practice.
Purpose of the Study:
- To design and evaluate a clinician-facing HBPM report prototype.
- To assess the utility and usability of integrated HBPM data for managing HDPs.
- To identify barriers and facilitators for integrating HBPM reports into obstetric workflows.
Main Methods:
- A mixed-methods study involving interviews with 16 obstetric providers.
- Iterative refinement of HBPM report prototypes with a multidisciplinary Clinician Advisory Group.
- Synthesis of qualitative and quantitative data on provider preferences, usability, and workflow integration.
Main Results:
- Providers found blood pressure graphs, abnormal value alerts, medication adherence tracking, and symptom logs highly useful (≥90%).
- Most providers preferred self-review of reports and flexible reporting frequency based on clinical need.
- Key barriers identified include workflow burden, triage of abnormal readings, and electronic medical record (EMR) integration.
Conclusions:
- The designed HBPM report elements are valuable for managing HDPs.
- Workflow and implementation challenges are significant barriers to clinical integration.
- Strategies are needed to overcome these barriers and support the adoption of HBPM tools in HDP care.
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01:15Assessment of blood pressure in brachial artery(one-step method)
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Prepare for the Procedure:
Prepare for the Procedure:
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the patient.
01:28Special considerations while measuring blood pressure
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:25Errors occurring during blood pressure monitoring
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
01:23Assessment of blood pressure in brachial artery(two-step method)
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01:19Assessing Blood pressure using a doppler ultrasound
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Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
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