Mount Sinai’s Dr. Sandy Logan and
colleagues first in Canada to show
improved blood pressure control in
diabetics, via smart phones
For the six million Canadians living with high blood pressure, a new smartphone application has the potential to put the power back in the patients’ hands.
Dr. Alexander Logan, a nephrologist at Mount Sinai Hospital, together with Dr. Joseph Cafazzo from the University Health Network’s Centre for Global eHealth Innovation, have developed an app where patients can measure their blood pressure at home and receive immediate feedback from their smartphone about how to stay on track and informing them of any concerns.
The telemonitoring system automatically delivers self-measured blood pressure readings and a progress note to patients via their smart phones after each blood pressure measurement. It also keeps a digital record of all readings, creates messages based on all stored information, sends progress reports to health-care providers, and reminds patients to follow their measurement schedule.
Current home blood pressure monitoring models require a physician or health-care team member to review the patients’ data and contact the patient for any adjustments to treatment. This approach is cumbersome and costly, and messaging lacks timeliness.
The study published in the July issue of Hypertension found that in the randomized controlled trial, 51 per cent of the patients who received progress notes and coaching messages on their phones achieved their target blood pressure levels, versus only 31% of control patients. And the blood pressure improvements were obtained with no additional medications or visits to physicians, thereby relieving undue burden to the health-care system.
“Home blood pressure telemonitoring with self-care support not only alleviates stress for health-care providers, but it empowers patients to take charge and become more involved in their own care,” said Dr. Logan. “What we’ve learned is that home blood pressure monitoring systems are not helpful without that linkage to a support system. That is where this system is different—we are eliminating the need for constant visits to the doctor while still providing support to our patients.”
Another innovative aspect of the self-care blood pressure telemonitoring system is its use of smart phone and Bluetooth technology. Several other mobile applications available to smart phone users can monitor blood pressure, but require patients to manually enter their information—a daunting task for patients who are not technologically savvy. Also, results are sent to their physicians for review and feedback, meaning that clinicians are still taking a lead role in providing support for blood pressure monitoring, even without patient visits.
“Often, calls from patients about blood pressure readings and results are given to health-care assistants to review, adding time and cost to our health-care system,” said Dr. Logan. “Patients now have easy access to informed care at anytime from anywhere. Harnessing this power has the potential to radically change the way healthcare will be delivered to patients with chronic illnesses. Here, the system empowers patients to make informed decisions about their own health.”
The study was funded by The Heart and Stroke Foundation of Ontario.