Getting a Bigger Picture with Home Blood Pressure Monitoring at Platte Health Center Avera
Summary
At Platte Health Center Avera’s clinics in Geddes, Platte, and White Lake, the self-monitoring blood pressure program is valuable in assisting providers in providing better care. Having access to home readings provides a bigger picture than random office readings.
Results
We have many examples where we have identified patients with elevated blood pressures in the clinic and sent a machine home with the patient. The home readings provided a bigger picture and confirmed the diagnosis, so the provider could confidently start appropriate treatment.
We have also identified several patients who have had elevated readings in the clinic but home readings provided a bigger picture with readings at home being in the normal range, confirming a diagnosis of white coat hypertension.
Interestingly, we recently had a case of a patient who had an elevated reading in the office, 156/92, so was sent home with a machine. When he returned for his follow up visit 2 weeks later, his blood pressure in the office was within normal limits,133/87, which in most cases a provider would have saw as normal and moved on. However, in reviewing his home readings log, the provider could see the bigger picture and noted that his home readings were still running high, averaging 157/99. This patient had a significant heart history and had recently had knee surgery. The bigger picture created with the home blood pressure readings allowed the provider to provide better care, consulting with cardiologist and orthopedist.
Over the last year, the trio of health clinics has enrolled almost 60 participants.
Solutions
We implemented our home blood pressure monitoring program a little over a year ago starting in White Lake in November 2021. With this program, we know the machines used at home are being validated every year so we trust the readings are accurate. Also, we are educating the patients on appropriate blood pressure technique and factors that can affect blood pressure so we are limiting this variability as well.
Challenges / Barriers
Prior to the implementation of our home blood pressure monitoring program, providers were having to make decisions regarding blood pressure control, based on one or two readings done in the office.
Some patients had their own home blood pressure machines, but accuracy is sometimes a concern with these.
