Success Story: Using Home Blood Pressure Monitoring for Hypertension Control Success
Hunterdon Cardiovascular Associates, PA, Flemington, New Jersey (2019)
The Challenge
Hunterdon Cardiovascular Associates (HCA) is a practice of 13 cardiologists and 10 advanced primary providers who together serve more than 12,000 patients in Flemington, New Jersey. Within the cardiology practice are clinics that focus on congestive heart failure, peripheral vascular disease, and atrial fibrillation. The patients are insured and mostly covered by Medicare.
About half of HCA patients have been diagnosed with hypertension, and of those, 2 out of 3 have high blood cholesterol, 1 of 3 have coronary artery disease, and 1 of 4 have diabetes. Helping patients address modifiable risk factors, such as physical inactivity and unhealthy diet, is the greatest challenge.
“The overall model of a health care system where patient care is shared among primary and specialist is the key to successful management of any comorbid condition. The health care system of which our practice is a part is committed to a healthy community and healthy workforce. Shared health care goals of patient and the provider are co-managed in a team approach of care.”
The Solution
HCA supports patients in their hypertension control journey with a combination of team-based care and at-home blood pressure monitoring. Patients with hypertension are often referred to HCA from their primary care practices or after experiencing a cardiac event. HCA encourages patients to purchase a home blood pressure monitor and to keep a log of their blood pressure numbers.
A team of cardiologists, nurses, and medical assistants work with patients to discuss the home readings, prescribe needed medications, and reinforce correct measurement techniques. The practice also offers resources to help patients address risk factors that have a lasting impact on blood pressure, such as exercise and smoking cessation.
HCA was able to establish a hypertension control rate much greater than 80% among its patients in 2019.
Strategies for Success
To achieve hypertension control, HCA used the following approaches:
- Implemented at-home blood pressure monitoring and regularly validated patient monitors with the practice’s monitors
- Employed 24-hour ambulatory monitoring (when reimbursed)
- Provided blood pressure measurement training to medical and nursing assistants
- Relied on alerts from electronic medical records when blood pressure readings were out of range
- Connected patients with dietitians, smoking cessation counselors, and the Walk with a Doc program
- Designated specific clinical staff for managing patient medication
- Used an integrated delivery system with a universal charting system for their health care model
“HCA empowers patients to take control of their blood pressure management through various avenues—including strong patient education—to ensure adherence to medical therapy and educating individuals on the importance and impact of healthy lifestyle changes.”
—HCA advanced practice provider