980: Utility of remote hypertension monitoring at reducing need for in-office blood pressure assessment

Hypertensive disorders of pregnancy (HDP) are a major contributor to postpartum maternal morbidity and mortality. Historically, compliance with in-person postpartum visits is poor and innovative interventions to improve adherence to care in this period are needed. We sought to assess the impact of replacement of the in-office blood pressure (BP) check with a remote hypertension telehealth monitoring program in women with HDP. This is an ongoing quality improvement project utilizing nursing call center-driven BP management that included women with a HDP. Eligible women are enrolled by their primary obstetric provider while inpatient in the postpartum period into either a medication or non-medication group based on the need for medication at the time of discharge. Women are prompted to report BP via secure text message 3-5 times per week depending on the need for anti-hypertensive medication. If all BPs are at goal, the one week postpartum in-office BP check is canceled and the patient continues remote monitoring (Figure). We utilized Geocoding from patient’s home addresses to an in-office BP check to assess the distance traveled and travel time saved through our remote monitoring program. A total of 550 women participated in the program between January 2018 and April 2019, with 351 women (63.8%) requiring an office BP check and 199 (36.2%) not requiring a visit. Women reported a median of 15 [7-20] BPs through the program. Compliance was 88.1% in the first week with 541 (98.4%) women reporting at least one BP in the first ten days postpartum. Women saved a median of 26.3 minutes [IQR 17.3-39.6] and 12.8 miles [IQR 7.4-26.1] one-way by averting an in-person BP assessment. Replacement of the in-office BP assessment with remote blood pressure monitoring saved an aggregate total of 11,008 miles and 15,489 minutes of travel time round-trip among 199 women. Remote monitoring programs for postpartum hypertension may reduce the travel time and burden related to in-office BP checks. Such programs may be particularly useful in reducing barriers to care in the postpartum period.View Large Image Figure ViewerDownload Hi-res image Download (PPT)