129: The effect of a remote blood pressure monitoring program on postpartum healthcare utilization

The use of remote monitoring has been proposed to improve patient engagement and reduce maternal morbidity during the postpartum period. We sought to compare healthcare utilization in women enrolled in remote monitoring versus a historical cohort of women with a diagnosis of a hypertensive disorder of pregnancy (HDP). This project utilizes nursing call center-driven blood pressure management that includes women with HDP admitted to the postpartum unit of a single tertiary care hospital. Eligible women are enrolled in the program by their obstetric provider into either a medication or non-medication group based on the need for anti-hypertensive therapy at discharge. Women are prompted to take and report blood pressures via text-messaging enabled smartphones between 3-5 times per week. Electronic medical record review was performed on women in the remote monitoring program compared to a cohort of women with HDP six months prior to the onset of program enrollment. Maternal, obstetrical and healthcare utilization data were compared using univariate analysis with chi-square and student’s t-tests. A total of 340 women were enrolled in the program between January 2018 and December 2018. Compared to the historical cohort, women in the remote monitoring group had a lower BMI, were more likely to have private insurance, and delivered at an earlier gestational age. 41 (12.2%) women in the remote monitoring group compared with 31 (8.0%) women in the historical cohort were readmitted within 56 days of delivery. Attendance at the postpartum appointment was significantly higher in the remote monitoring group (Figure). We demonstrate that women enrolled in a remote hypertension monitoring program are more likely to follow-up for their postpartum visit than those in the historical cohort. Additionally, there is a trend towards an increased number of hospital readmissions in this population. We hypothesize that this may be secondary to increased recognition of complications related to hypertension. However, further analyses are needed to ascertain a reduction in postpartum morbidity.