Decoding New York State’s Prescription Monitoring Program

Introduction: We assessed the efficacy of mobile healthhypertension monitoring for patients enrolled inMedicare’s Remote Physiologic Monitoring (RPM)program. Hypothesis: Uncontrolled hypertension is an increasingepidemic associated with cardiovascular disease.Despite many available treatments, the averagetime to blood pressure control is slow. Lack ofaccess to patient information including bloodpressure data outside of the clinic setting meansthat clinicians cannot easily titrate medications. Wehypothesized that mobile health monitoring andcommunication with clinicians in a Medicare cohortwould decrease the hypertension burden andmitigate crisis blood pressure in patients. Methods: 1,544 patients who had contributed ≥ 20 bloodpressure readings in a remote monitoring programwere included in the study population, spanningclinics in Florida, Tennessee, Arizona, Ohio, Texas,New York, and California. Eligible patients carried adiagnosis of hypertension and had been seen bytheir doctor within the year they were referred. Themobile health platform was utilized to aggregateblood pressure data, which was analyzed by aremote care team and provided to clinicians on amonthly basis. Patients’ doctors and their teamsreviewed and managed the patients based on thedata provided by the mobile-cloud platform. Theremote monitoring program provided alerts to clinicstaff for patients who had blood pressures greaterthan 180mm Hg systolic (crisis hypertension) forexpedited decision making. Results: 1,544 patients who provided >20 BP readingsfrom January 2018 to January 2020 wereincluded in the study. A total of 297,731 bloodpressure readings were included in thisanalysis. Patient readings were stratified byepoch chronologically. The first epoch (E1),represented the first 25% of readings in theremote monitoring system, and the fourth epoch(E4) represented the final 25% of readings.From E1 to E4, patients saw an averagedecrease of 3.8 mmHg in systolic bloodpressure (132.9 vs. 129.1; p<0.001). Theproportion of readings in crisis hypertensionrange decreased from 2.3% to 1.1%; p=0.03). Conclusions: RPM offers a scalable solution to resistant hypertension.

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Water quality response to riparian restoration in an agricultural watershed in Vermont, USA

Water Science & Technology ◽

10.2166/wst.2001.0280 ◽

2001 ◽

Vol 43 (5) ◽

pp. 175-182 ◽

Cited By ~ 26

Author(s):

D. W. Meals

Keyword(s):

New York ◽

Management Practices ◽

Monitoring Program ◽

Cost Effective ◽

Agricultural Watershed ◽

Riparian Restoration ◽

Lake Champlain ◽

Grab Sampling ◽

National Monitoring ◽

Treatment Techniques

Achievement of management goals for Lake Champlain (Vermont/New York, USA and Quebec, Canada) will require reduction of agricultural phosphorus loads, the dominant nonpoint source in the Basin. Cost-effective phosphorus reduction strategies need reliable treatment techniques beyond basic cropland and waste management practices. The Lake Champlain Basin Agricultural Watersheds National Monitoring Program (NMP) Project evaluates the effectiveness of livestock exclusion, streambank protection, and riparian restoration practices in reducing concentrations and loads of nutrients, sediment, and bacteria in surface waters. Treatment and control watersheds in northwestern Vermont have been monitored since 1994 according to a paired-watershed design. Monitoring consists of continuous stream discharge recording, flow-proportional sampling for total P, total Kjeldahl N, and total suspended solids, grab sampling for indicator bacterial, and land use/agricultural monitoring. Strong statistical calibration between the control and treatment watersheds has been achieved. Installation of riparian fencing, protected stream crossings, and streambank bioengineering was completed in 1997. Early post-treatment data suggest significant reduction in P concentrations and loads and in bacteria counts in the treated watershed. Monitoring is scheduled to continue through 2000.

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