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Mount Sinai Hospital
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(June 15, 2012—Toronto, ON) Researchers from Mount Sinai Hospital, in collaboration with the Centre for Global eHealth Innovation, University Health Network, are leading an innovative study on the effects of home blood pressure telemonitoring plus self-care support in diabetic patients with uncontrolled hypertension.
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.
The lead author, Dr. Sandy Logan, Mount Sinai physician and scientist at the Hospital’s Samuel Lunenfeld Research Institute, and Dr. Joseph Cafazzo, Centre Lead and Director of Medical Device Informatics and Healthcare Human Factors at the University Health Network published their results online last month. The study will appear the July issue of Hypertension.  
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.
In the randomized controlled trial, 51% 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. We keep adding additional layers of support to our patients, which is increasing costs to our health-care system,” said Dr. Logan. “Unlike the currently available mobile applications, which can actually be restrictive depending on a user’s comfort level with technology, we wanted to design a system that doesn’t perpetuate a paternalistic model of care. 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.

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