I discussed in previous posts the impacts of hypertension and the challenges doctors and patients face in overcoming this silent killer. The most common is patient noncompliance with diagnostic (30%) and treatment (50%) protocols. I also highlighted studies that found uncontrolled blood pressure (bp) prevalent among patients under pharmacological treatment. These findings point to multiple process barriers that emerging technologies can help address. I found potential solutions in our comparison of legacy bp diagnostic-monitoring methods and Biobeat’s innovative 24BP profiling system.
I consulted with clinicians to benchmark legacy diagnostic and post-treatment bp monitoring to better understand legacy protocols and underlying processes. The resulting model incorporated their inputs through checkups, follow-ups, ambulatory bp monitoring, (ABPM) and profiling (Figure 1). ABPM has been the Gold Standard in bp profiling because it offers a comprehensive view of blood pressure as patients go about their day. The current legacy system uses a waist-mounted unit and cuff to capture multiple bp and heartrate measurements over 24 hours. The data is then downloaded and sent for analysis. A report is then forwarded to the Primary Care Physician (PCP) to guide the development of treatment and monitoring plans.
The process can take up to a month to complete depending on each provider’s protocols, insurance approvals, ABPM availability, and patient cooperation. Patients are usually reevaluated 30 – 60 days after treatment starts using the same monitoring protocols.
I next benchmarked a newer approach based on Biobeat’s BP24 profiling system (Figure 2). It uses a disposable monitoring patch that is attached to the patient’s upper chest and worn for 24 hours. The patch uses new cuffless technologies to continuously measure and transmit streams of bp readings to cloud servers. After 24 hours, the patient removes the disposable patch, which eliminates concerns over the hygiene of reusable ABPM units.
The BP24 cloud-based system automatically analyses bp data after monitoring ends using advanced analytics and artificial intelligence. The results are sent to patients and their PCP within a few hours. The bp profile report also includes cardiac output and systemic vascular resistance measurements to help physicians better understand the underlying causes of their patients' hypertension and adjust treatment plans accordingly. Patients are re-evaluated 30 – 60 days after treatment begins using the same BP24 based process.
Table 1 quantifies the legacy bp/ABPM and BP24 based processes through the diagnostic and treatment planning stages. Similar metrics were captured for treatment and post-treatment monitoring. The results were analyzed from patient, clinician, quality, and financial perspectives. Upcoming posts will discuss their implications for doctor-patient collaboration, patient compliance, and decision-making.
US military in public domain
Ozzie Paez and OPRHealth