Since COVID-19 swept across the country, there have been an abundance of care venues shifting to a telehealth-first approach. While an internet-based form of health care may be new to both patients and providers, the research to support this method of care has been around for decades. There are many different approaches that a provider can take to ensure the best quality of care in a telehealth setting. This guide will focus on the use of health coaches (sometimes referred to as care coordinators or health navigators) in Remote Patient Monitoring (RPM) of hypertensive patients.
Health Coaching for Hypertension Overview
Health Coaching is a telehealth treatment option where a patient regularly confers with a health and wellness coach. This method of treatment can be used for patients with or without a chronic medical condition as the purpose of a health coach is to help the patient set and create goals for their health, as well as provide a variety of strategies to help the patients achieve said goals.
Health coaches can specialize in a variety of health issues including, but not limited to, stress reduction; improving exercise and diet regimens; or the management of chronic conditions such as hypertension.
In the United States, nearly one in two adults has hypertension, and approximately one in five of these adults with hypertension are recommended to make lifestyle modifications.¹ Studies have shown that medications alone are not effective in the management of hypertension. Along with patient drive and willingness, health coaching and appropriate tools are necessary in the proper management of hypertension.²
Remote Patient Monitoring Overview
RPM gathers patient data through the use of technology in order to deliver direct patient care outside of a traditional health care setting. This can be achieved through the use of different home monitoring devices, such as automatic blood pressure cuffs or glucose monitors, that a patient can use on a consistent basis. These readings will then be recorded electronically for a health care provider to analyze.
A benefit of this method of monitoring is that providers are now able to reach a broad range of individuals who may not have access to health care resources they need in order to remain, or become, healthy.
Home monitoring products that are simple and easy to use allow patients across all age groups, including seniors, to utilize technology to manage their own health. In this way, they feel comfortable and motivated to continue with their home monitoring.
While getting the patient invested in consistently completing health readings is important, data shows that the best health outcomes result from the dual treatment of RPM and health coaching.
Enhancement of Hypertension RPM Through Health Coaches
Studies have shown that RPM itself has the ability to improve a patient’s hypertension, however when paired with health coaching, the patient makes even further progress in managing their chronic condition.
In a pilot study completed in 2020, student health coaches were recruited in order to improve digital blood pressure management. The participants were assigned to three groups of treatment. One was instructed to meet with a health coach for 30 minutes once a week, one was given a blood pressure cuff and instructed to utilize it daily, and the last group received both forms of intervention. At the end of the study, all groups reported better blood pressure control. There was a significant difference in the frequency of the cuff used in the group that met with the health coaches, as opposed to those who just received the cuff: – 37 vs 17; P<.001. The average blood pressure in each group at the end of the study were as follows:
- 150/85 in individuals who just met with a health coach
- 145/84 in individuals who just received a blood pressure cuff
- 128/69 in individuals who received both forms of intervention ³
This study showcases how health coaches can improve both patient adherence and health status when paired with RPM. When the patients are given the proper tools needed to monitor their hypertension, ex.. a blood pressure cuff, and given the open communication with a health coach that gives the patient a sense of accountability, results are seen.
Another benefit of utilizing health coaches concurrently with hypertension RPM is the broad spectrum of community based organizations who can utilize these services, such as Federally Qualified Health Centers (FQHC).
In a quality improvement project implemented at the Ryan Adair Center, a FQHC in Central Harlem, predominantly Black and Latino patients on Medicaid who lived well below the federal poverty line were given the chance to work with a health coach through RPM to improve their blood pressure control. The health coaches began educating the patients on proper blood pressure measurements and how to utilize the technology while stressing the importance of maintaining a daily log. Health coaches then met with patients and monitored their blood pressures for six months. In February of 2019, when the project started, 59 percent of the hypertensive patients had controlled blood pressure, measured as a blood pressure under 140/90. At the end of this study, July of 2019, 73 percent of patients had controlled blood pressure.⁴
With RPM and health coaches having the ability to treat patients regardless of backgrounds or financial status, there is an opportunity to decrease the total population of patients with unmanaged hypertension.
How Can We Help
Certintell’s mission is to deliver comprehensive primary care services to patients through telehealth. We have certified clinical health coaches who are fully-trained in remote patient monitoring and how to help underserved patients treat their hypertension. We are able to provide patients with remote patient monitoring devices and a portal in order to achieve direct care through data analysis. Our health coaches are able to help guide patients through the new technology involved with RPM, as well as help patients achieve their goals in improving their health.
Contact us today at 1-800-946-9143 to learn more or schedule a demo below in a few clicks:
¹ Centers for Disease Control and Prevention (CDC). “Estimated Hypertension Prevalence, Treatment, and Control Among US Adults.” Million Hearts. 22 March 2021. https://millionhearts.hhs.gov/data-reports/hypertension-prevalence.html
² Crittenden D, Seibenhener S, and Hamilton B. “Health Coaching and the Management of Hypertension.” The Journal for Nurse Practitioners. 1 May 2017. https://www.npjournal.org/article/S1555-4155(17)30130-7/pdf
³ Eysenbach G. “Recruiting Student Health Coaches to Improve Digital Blood Pressure Management: Randomized Controlled Pilot Study.” US National Library of Medicine. 25 August 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479581/
⁴ Anand S, Santillan Y, Issaath A, et al. “Abstract 261: Improving Hypertension Control Among an Underserved Urban Patient Population” Circulation: Cardiovascular Quality and Outcomes. 14 May 2020. https://www.ahajournals.org/doi/10.1161/hcq.13.suppl_1.261