scholarly journals Workflow Automation for a Virtual Hypertension Management Program

2021 ◽  
Vol 12 (05) ◽  
pp. 1041-1048
Author(s):  
Samuel Aronson ◽  
Benjamin M. Scirica ◽  
William J. Gordon ◽  
Alexander J. Blood ◽  
Kira Chaney ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Management Program ◽  
Customer Relationship ◽  
Hypertension Management ◽  
Pressure Data ◽  
Workflow Automation ◽  
Device Integration ◽  
Blood Pressure Data

Abstract Objectives Hypertension is a modifiable risk factor for numerous comorbidities and treating hypertension can greatly improve health outcomes. We sought to increase the efficiency of a virtual hypertension management program through workflow automation processes. Methods We developed a customer relationship management (CRM) solution at our institution for the purpose of improving processes and workflow for a virtual hypertension management program and describe here the development, implementation, and initial experience of this CRM system. Results Notable system features include task automation, patient data capture, multi-channel communication, integration with our electronic health record (EHR), and device integration (for blood pressure cuffs). In the five stages of our program (intake and eligibility screening, enrollment, device configuration/setup, medication titration, and maintenance), we describe some of the key process improvements and workflow automations that are enabled using our CRM platform, like automatic reminders to capture blood pressure data and present these data to our clinical team when ready for clinical decision making. We also describe key limitations of CRM, like balancing out-of-the-box functionality with development flexibility. Among our first group of referred patients, 76% (39/51) preferred email as their communication method, 26/51 (51%) were able to enroll electronically, and 63% of those enrolled (32/51) were able to transmit blood pressure data without phone support. Conclusion A CRM platform could improve clinical processes through multiple pathways, including workflow automation, multi-channel communication, and device integration. Future work will examine the operational improvements of this health information technology solution as well as assess clinical outcomes.

scholarly journals Differences in resting and ambulatory blood pressure data in coarctation of aorta vs idiopathic hypertension

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Egbe ◽  
K Banala ◽  
R Vojjini
Keyword(s):  
Blood Pressure ◽  
Clinical Decision Making ◽  
Arterial Compliance ◽  
Pressure Overload ◽  
Clinical Decision ◽  
Left Ventricular ◽  
Coarctation Of Aorta ◽  
Masked Hypertension ◽  
Lv Remodeling ◽  
Blood Pressure Data

Abstract Background Ambulatory systolic blood pressure (SBP) is more sensitive than resting-SBP in detecting hypertension in patients with coarctation of aorta (COA) and patients with idiopathic hypertension. A recent study showed that compared to patients with idiopathic hypertension with similar resting-SBP, COA patients had lower arterial compliance, and hence experienced higher SBP per unit increase in stroke volume during exercise. The purpose of this study was to compare resting vs ambulatory-SBP relationship between COA patients and non-COA patients (with and without hypertension), and to determine if ambulatory-SBP had better correlation with left ventricular (LV) remodeling as compared to resting-SBP. Methods Case-control study of 106 COA patients and 106 patients with idiopathic hypertension (ControlHTN+ group) matched by age, sex, body mass index and resting-SBP. Resting/ambulatory BP relationship in COA patients and patients with idiopathic hypertension were also compared to that of 19 patients without hypertension (ControlHTN- group). LV remodeling was assessed using LV mass index, e', and E/e'. Results Although the COA and ControlHTN+ groups had similar resting-SBP (by design), the COA group had a higher ambulatory-SBP and a higher prevalence of masked hypertension (30% vs 12%, p<0.001). There was a stronger correlation between ambulatory-SBP (as compared to resting-SBP) and LVMI (r=0.36 vs r=0.55, p=0.042), and average E/e' (r=0.42 vs r=0.59, p=0.046), in the COA group but not the ControlHTN+ group. There was no difference in the resting/ambulatory BP relationship between ControlHTN+ and ControlHTN- groups, but both groups were significantly different from the COA group. Conclusion These results highlight the unique differences in disease pathophysiology between hypertension in patients with COA and those with idiopathic hypertension, and also suggest that ambulatory-SBP may be a more accurate measure of LV pressure overload in COA patients. This underscores the potential limitations of relying on resting-SBP alone for clinical decision making. Funding Acknowledgement Type of funding source: None

Comparison of 24-Hour Ambulatory Blood Pressure Data in Hypertensive Patients Switched from Nifedipine-GITS to Nifedipine-CC

1999 ◽  
Vol 19 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Richard L. Wurdeman ◽  
Aryan N. Mooss ◽  
Syed M. Mohiuddin ◽  
B. Daniel Lucas ◽  
Kay L. Ryschon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Pressure Data ◽  
Hypertensive Patients ◽  
Blood Pressure Data

scholarly journals Efficacy of a Culturally and Linguistically Competent Community Health Coach Intervention for Chinese with Hypertension

2020 ◽  
Vol 5 (3) ◽  
pp. 111-119
Author(s):  
Wen-Wen Li ◽  
Donna Lew ◽  
Linda Quach
Keyword(s):  
Blood Pressure ◽  
Community Health ◽  
Blood Pressure Control ◽  
Chinese Immigrants ◽  
Pressure Control ◽  
Management Program ◽  
Hypertension Management ◽  
Health Coach ◽  
Cross Sectional ◽  
Question And Answer

Purpose: To develop and pilot test the efficacy of a culturally and linguistically sensitive, community health coach (CHC)-based intervention in Chinese immigrants in improving blood pressure control and medication adherence. Design: This study was conducted in 2017 with a cross-sectional design (n = 23). A CHC intervention was implemented using one 25-minute group educational presentation plus one 10-minute question and answer session at baseline, followed by four, 10-minute bi-weekly group question-and-answer sessions. Findings: There was a significant reduction in both systolic and diastolic blood pressure from baseline to week 8: Systolic BP −17.33 (±11.32) (p < 0.005) and diastolic BP −9.58 (±6.57) (p < 0.005). The mean score for medica- tion adherence was 10.56 (±3.24) (possible range 3–15) at baseline and there was no significant change at week 8 (mean 10.89 ± 3.95) (p = 0.86). Conclusion: The CHC-based hypertension management program showed significant reductions in both systolic and diastolic blood pressures in Chinese immigrants. Since the proposed CHC-based hypertension management program is low cost and easy to establish, further investigation is recommended to generate more results for comparison. Practice Implications: There is potential for the CHC intervention to be implemented in clinical settings to help Chinese immigrants at large achieve optimal blood pressure control.

Abstract TMP89: Collaterals and Reperfusion Mediate Blood Pressure Changes in Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
David S Liebeskind ◽  
Graham W Woolf ◽  
Nerses Sanossian ◽  
Jason D Hinman ◽  
Radoslav Raychev ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Endovascular Therapy ◽  
Arterial Occlusion ◽  
Patient Specific ◽  
Pressure Data ◽  
Blood Pressure Data ◽  
Pressure Changes ◽  
Continuous Blood Pressure

Background: The pathophysiology and optimal management of blood pressure changes in acute ischemic stroke remain unknown. Blood pressure guidelines do not consider patient-specific or serial data on dynamic blood pressure readings. We investigated continuous blood pressure data during endovascular therapy for acute stroke to discern changes associated with collaterals, recanalization and reperfusion. Methods: Continuous monitoring blood pressure data was collected in consecutive cases of endovascular therapy for acute ischemic stroke due to ICA or proximal MCA occlusion. Angiography details were independently analyzed to document site of arterial occlusion, baseline collateral grade, time of device deployments, time of recanalization, time of final reperfusion, final AOL recanalization and final TICI reperfusion. Statistical analyses correlated instantaneous and serial blood pressure changes with these angiographic parameters. Results: 80 patients (median age 73 years; 33 women) were studied. Arterial lesions included 37 ICA and 41 proximal M1 MCA occlusions. Collateral grade prior to intervention included 2 ASITN grade 4, 26 grade 3, 23 grade 2, 6 grade 1 and 0 grade 0. oTICI2C reperfusion scores after thrombectomy included 2 TICI 3 (100%), 22 TICI 2C (90-99%), 25 TICI o2B (67-89%), 9 TICI m2B (50-66%), 19 TICI 2A (<50%) and 3 TICI 0/1. More robust collateral grade was associated with greater reperfusion scores (r=0.32, p=0.028). The change in blood pressure (ΔBP) from earliest BP to time of recanalization was mean 59% of ΔBP during the entire procedure. Better collaterals were associated with lower BP prior to recanalization (r=-0.377, p=0.012). Lower BP prior to recanalization was linked with greater TICI reperfusion (r=-0.242, p=0.050). Higher TICI reperfusion scores were also associated with a greater drop or ΔBP at the time of recanalization (r=0.269, p=0.031). AOL recanalization was not related to ΔBP. Conclusions: Collaterals and reperfusion, but not recanalization, mediate blood pressure changes in acute ischemic stroke. Prospective, precision medicine stroke studies should leverage patient-specific, real-time data on continuous blood pressure with imaging correlates to define BP goals of future in-hospital management.

Heterogeneity among hypertensive subjects: a tool for clinical decision-making

1991 ◽  
Vol 37 (10) ◽  
pp. 1885-1890 ◽  
Author(s):  
M H Alderman
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Management Strategy ◽  
Clinical Decision Making ◽  
Adverse Outcome ◽  
Blood Pressure Measurement ◽  
Clinical Decision ◽  
Pressure Control ◽  
Treatment Progress ◽  
The Status

Abstract Current antihypertensive treatment strategy tends to approach all patients similarly, with decision to treat, the goal of treatment, and medication use based largely on blood pressure measurement. Clearly, it would make far more sense if a management strategy could be developed that was not solely dependent on measurement of blood pressure, but rather reflected a clearer understanding of individual likelihood of adverse outcome, the nature of blood pressure control, and the importance of associated clinical and biological characteristics. New tools make it possible to accurately assess the status of the heart, kidney, and blood vessels, both as a guide to the need for therapy and as a measure of treatment progress when the treatment is used. New understanding of the vasoconstrictor and volume contributions to blood pressure control coupled with a rich armamentarium of therapeutic agents make it possible to tailor therapy more appropriately. Finally, growing awareness of the contribution of concomitant risk factors has made it clear that overall success depends on attention to the whole patient.

Normative blood pressure data in non-ventilated premature neonates from 28–36 weeks gestation

2009 ◽  
Vol 24 (1) ◽  
pp. 141-146 ◽  
Author(s):  
Alison L. Kent ◽  
Sandra Meskell ◽  
Michael C. Falk ◽  
Bruce Shadbolt
Keyword(s):  
Blood Pressure ◽  
Pressure Data ◽  
Premature Neonates ◽  
Blood Pressure Data
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