Remote Patient Monitoring for Hypertension [Complete Guide]

Understanding Remote Patient Monitoring (RPM) for Hypertension

For decades, hypertension care relied mostly on in-person visits to a provider's clinic or office. Medication and lifestyle adjustments could only be based on blood pressure readings taken at the clinic during follow-up visits.

However, the traditional approach has proven inadequate. It's significantly limited for the following reasons:

• Data points are quite infrequent.
• Patients show lower adherence due to the long gaps between visits.
• Snapshot readings can't capture usual blood pressure patterns.
• In-person visits are a significant burden to patients, especially if they're aging.
• Some patients record elevated readings in clinical settings (white-coat hypertension).
• As a provider, you may not have the time to provide extensive attention during each visit when dealing with many patients.

A smarter strategy, given this reality, is to find a way to reliably and accurately collect and transmit patient data from their homes.

Remote patient monitoring for hypertension, with the help of RPM devices and platforms like KangarooHealth, now makes such an intervention possible.

RPM Devices for Hypertension Management

Hypertension patients have always had access to home blood pressure monitors. So, how are RPM devices for hypertension different from these traditional monitors?

First, you must appreciate what an RPM program would want to achieve. If the goal is to transition from sporadic self-reported measurements to a continuous stream of accurate data, connectivity is essential.

For that, you'll typically need at least one of the following RPM devices:

• Cellular-enabled cuffs: They can automatically transmit readings without needing patient-provided smartphones or internet.
• Bluetooth-enabled cuffs: They require the patient to pair the cuff with their smartphone or tablet. Typically, the patient uses an app to facilitate data transmission.
• Wi-Fi-enabled cuffs: They connect to the patient's Wi-Fi network to transmit data directly. They aren't as common as the other two cuffs mentioned above.
• Wearables: Include patches and wristbands. They use optical sensors or company-proprietary technology to continuously monitor blood pressure.

Second, RPM devices for hypertension exist in an ecosystem. The data must be transmitted to a portal or cloud platform. Therefore, the selected device(s) must be able to integrate seamlessly with this portal/platform.

This is where KangarooHealth comes in. Our platform has been tried and tested across several remote patient care settings and is efficient, cost-effective, and highly scalable.

We typically use cellular-connected devices that transmit data without relying on patient-provided smartphones, Bluetooth, or Wi-Fi. Also, we provide a maximum of two devices per patient to ease adherence and reduce the likelihood of tech overwhelm.

Benefits of RPM for Hypertensive Patients and Providers

As the above study of Medicare patients showed, RPM can have a transformative impact on health outcomes for hypertensive patients.

Many other providers and researchers also report significant improvements in health outcomes and cost control.

Let's explore some common benefits you can expect from an RPM program for hypertension:

Improved Blood Pressure Control

Remote blood pressure monitoring provides continuous, real-time data. With increased visibility, you can facilitate timely interventions and make personalized adjustments that simply aren't possible in a non-RPM setting.

For instance, a meta-analysis of remote blood pressure monitoring in urban-dwelling hypertensive patients found that patients under remote blood pressure monitoring had a 23.7% higher improvement in BP control than patients under usual care.

Improved Medication Adherence and Treatment Adjustments

A study analyzing adherence to antihypertensive medication among young adults found the following factors to be negatively associated with good adherence:

• Rural residence
• A smoking habit
• Frequent drinking
• Physical inactivity
• Lower household income

Because hypertension management depends on consistent adherence, you must find ways to reduce the risks the above factors pose.

Patients with lower household income and those in rural areas generally have limited access to healthcare and may have lower health literacy. Further, a digital divide exists where such populations have fewer digital tools for managing their chronic conditions.

Remote patient management for hypertension gives you the infrastructure for continuous oversight and communication with such patients.

Cellular-powered devices like the ones we use at KangarooHealth can work effectively even in the remotest rural areas with no reliable Internet.

Further, the improved visibility, communication, and the opportunity to provide personalized care can help you nudge patients with undesirable habits, like smoking and frequent drinking, towards healthier lifestyle choices, leading to significantly better health outcomes.

Significant Reductions in Adverse Events

A continuous stream of health data significantly increases the likelihood of spotting concerning patterns. You can then make proactive interventions to arrest adverse hypertensive events before they happen.

While RPM is unlikely to eliminate stage 2 hypertension from your entire patient population, nearly all patients will record significant improvements.

For instance, in the study with a 75% reduction in stage 2 hypertension, even the patients who still had stage 2 hypertension recorded a statistically significant decrease in mean and median blood pressure. Such improvements can help reduce the risk of complications.

Cost-Effective Healthcare Delivery

Reduced complications and fewer hospitalizations due to effective remote blood pressure monitoring can save both patients and providers money.

Most RPM programs can pay for themselves. For instance, a study estimating the program cost of RPM-HTN at NYU Langone Health's cardiology division saw an estimated 22.2% positive return on investment.

The program not only covered its costs, but also generated a profit.

How RPM Is Implemented in Hypertension Care

RPM programs for hypertension aim to provide personalized care to improve health outcomes. Therefore, you must tailor the program to the needs of your patients.

An RPM implementation in hypertensive care will generally involve the following steps:

1. Define program objectives first: What are you looking to achieve? Do you want to improve adherence? BP control? Hospitalizations? ER visits? Patient satisfaction?
2. Conduct a needs assessment: Which patient populations need the program? (E.g., stage 2, newly diagnosed, history of complications, rural, with white-coat hypertension, need for medication adjustments, etc.)
3. Assemble a team: You'll need a team with defined roles to work on clinical protocols, oversight, nursing/care coordination, and admin/billing. You can outsource tech support to an RPM platform provider.
4. Procure tech and define workflows/protocols: Next, decide on the RPM devices and a cloud platform. Also, you must establish protocols and workflows for every step of the program.
5. Train and onboard patients: Patients need comprehensive education during the onboarding phase. Aside from the “how”, you must also explain the “why” as it increases trust in the program and enhances adherence.
6. Monitoring, communication, and optimization: Your care team must monitor the incoming data regularly. Where necessary, offer additional education, symptom checks, medication reminders, or escalation when urgent care is required.

With continuous data coming in, you want to track key performance indicators (KPIs) against your stated objectives. You can then iterate and improve the program based on your knowledge.

Pro Tip: An RPM program is tech-heavy. You'll need RPM devices and a central portal or cloud platform. Your patients will also require tech support.

Also, implementing an RPM program alone can be a struggle. We aim to make the transition effortless by handing over a comprehensive turn-key program. We'll handle device selection, procurement, and distribution.

We'll also provide comprehensive patient education to ensure every user is adequately equipped for the program.

Talk to our team today to streamline your remote patient monitoring for hypertension, taking the tech and complex operations off your plate, so you and your care team can focus on what matters most.

Reimbursement and Compliance Considerations

Providers and regulators are increasingly recognizing telemedicine and e-health. Even so, you must stay compliant with all regulations to maximize your legitimate reimbursements.

KangarooHealth is designed to ease the complexity of billing and regulatory adherence. We also provide the billing support you need by using:

• Clear communication and guidance to help you navigate codes, documentation, and regulatory requirements.
• Built-in time and activity tracking to ensure accurate, compliant billing.
• Verifiable documentation so you are always ready in case of an audit.
• Ability to connect you with North American, in case you need assistance with billing and reimbursement.
• Using only FDA-cleared or FDA-approved devices to ensure compliance and build a solid foundation for reimbursements.

Challenges in RPM Adoption for Hypertension

RPM is incredibly effective at improving health outcomes. The adoption process, however, can have some challenges.

Some of the common challenges providers face while rolling out RPM for hypertension may include:

• Billing problems: There’s a learning curve to accurately tracking and billing the relevant RPM CPT codes. KangarooHealth provides the support you need to confidently navigate codes, documentation, and regulatory requirements.
• Digital literacy: Many patients will be older and may have low digital literacy. Adequate training is essential. KangarooHealth provides comprehensive patient education and matches every patient with a remote coach to support them every step of the way.
• RPM platform integration problems: Given the number of different devices out there, device integration can get challenging. KangarooHealth is device agnostic, meaning our RPM technology solution can integrate seamlessly with many FDA-cleared devices.

Frequently Asked Questions (FAQs)

Looking for more information about remote patient monitoring for diabetes? Let's answer some of the questions we commonly get:

How Accurate Are RPM Devices for Blood Pressure Monitoring?

RPM devices generally provide accurate blood pressure readings. Before being rolled out for medical use, RPM devices must be clinically validated and get FDA clearance.

Is There a Difference Between RPM and Self-Monitoring Logs?

Yes. The difference primarily lies in data transmission. With self-monitoring logs, the patient takes their BP reading and logs it on paper or a notes app.

With RPM, the reading is automatically transmitted to the provider's cloud-based system in real-time.

Is Remote Monitoring Safe for Elderly Hypertensive Patients?

With proper implementation, remote monitoring actually enhances safety for elderly hypertensive patients.

It leads to more accurate BP readings, better engagement, enhanced adherence, and earlier detection of complications. It also reduces the need for frequent in-person visits, which can be strenuous for elderly patients.

That said, certain BP monitors cannot work with individuals with a pacemaker. The design and execution of the RPM program should account for such vulnerabilities in elderly patients that may pose safety risks.

How Often Should Patients Check Blood Pressure with RPM?

The frequency should depend on the patient's specific condition. At the start, you can recommend frequent checks to establish baseline numbers. That data should inform the next course of action.

Also, there's a critical 16-day requirement for RPM reimbursement that you should keep in mind. Within a 30-day billing period, the patient must transmit at least one reading a day for 16 or more separate days.

Conclusion

Remote blood pressure monitoring is a reliable pathway to superior health outcomes for hypertensive patients. You can now empower your patients to adopt healthier lifestyles, enhance adherence, improve BP control, and reduce the risk of critical events.

Ready to unlock these benefits and more for your patients? Schedule a free consultation with our team to learn how we can help you seamlessly integrate RPM into your practice without disrupting your workflows or taking time away from patient care.

We handle device distribution and patient enrollment. We also provide comprehensive staff and patient training to ensure every user in the program is set up for success. Further, our platform is designed for efficiency, managing alerts with tailored escalation protocols so you can spend less time monitoring incoming data and more time with patients.