Abstract Body: Introduction
Despite clinical evidence supporting the use of self-measured blood pressure monitoring (SMBP)in improving blood pressure control, the infrastructure to enable data transfer from device to electronic health record (EHR) is complicated by policy, interoperability, and operational challenges. The National Hypertension Control Initiative (NHCI) engaged 350 HRSA-funded federally qualified health centers (FQHCs) to improve blood pressure control leveraging SMBP devices and integrating SMBP data into EHRs.
Hypothesis/Aims
FQHCs could integrate SMBP device data into their EHR with financial support and training and technical assistance (T/TA).
Methods
T/TA was provided through a curriculum to support technology infrastructure self-assessment, explore effective integration options, and implement solutions. Additionally, FQHCs were offered 1:1 consultations and EHR-specific guidance documents.
Results
More than half (52%) of responding FQHCs reported moving through all stages of planning, preparing, piloting, scaling, and evaluating their SMBP program during the 3-year grant, while 30% reached the scaling stage. Ultimately, 27% reported full data integration and 51% reported partial integration of SMBP device data into their EHR, while 4-12% reported no to minimal integration, respectively. Based on the five most used EHRs, numerous integrations were identified with five validated SMBP devices.
Successful integration strategies included upgrading to the latest EHR version, choosing SMBP devices with verified EHR integration, utilizing EHRs with patient portal apps, and engaging with remote patient monitoring (RPM) services for pre-established integrations. Third-party integration engines emerged as complex and expensive solutions. Challenges included costly or time-consuming EHR upgrades, SMBP device purchases without prior SMBP integration assessment, limitations posed by non-cloud based EHRs or EHRs without patient portals, ability to sustain RPM subscription costs, and limited information technology expertise.
Conclusion
SMBP device data can be integrated into EHRs, but the complexity, costs, and sustainability vary significantly. Several viable integration strategies with common EHRs and validated SMBP devices were verified. As the technology landscape evolves rapidly, the underlying need for education, strategic technology planning, and vendor collaboration remains.