How can health information technology (HIT) help address hypertension in the homeless population?

From the Guidelines

Health information technology can effectively address hypertension in homeless populations through targeted approaches, including mobile health clinics, portable blood pressure monitoring devices, text message reminder systems, cloud-based health records, and telehealth platforms, as supported by the most recent evidence from 2021 1.

Key Technologies for Hypertension Management in Homeless Populations

• Mobile health clinics equipped with electronic health records (EHRs) to track blood pressure measurements and medication adherence
• Portable blood pressure monitoring devices connected to smartphone applications for remote monitoring and timely interventions
• Text message reminder systems to prompt medication adherence for common antihypertensive medications like lisinopril, amlodipine, or hydrochlorothiazide
• Cloud-based health records accessible across different healthcare facilities to ensure continuity of care
• Telehealth platforms to enable virtual consultations with healthcare providers and reduce transportation barriers

Evidence Supporting the Use of Health Information Technology

The use of telemedicine and BP telemonitoring has been shown to improve hypertension management, particularly in patients with difficult to control hypertension or those with poor adherence to their antihypertensive regimen 1. A recent meta-analysis found that pharmacist-led interventions using home-based BP telemonitoring resulted in better BP control than usual care 1. Additionally, a study on the use of telemedicine in the management of hypertension concluded that current evidence supports the use of telemedicine and BP telemonitoring, particularly in patients with difficult to control hypertension or those with poor adherence to their antihypertensive regimen 1.

Implementation and Effectiveness

The most successful telemedicine approach appears to be the one based on telemonitoring of BP and tracking of additional vital and nonvital signs with data exchange between patients and a case manager, integrated with education on lifestyle, risk factors, and proper use of antihypertensive medications 1. Proactive intervention driven by healthcare professionals, rather than passive intervention, seems to provide the best and most long-lasting effects 1.

From the Research

Addressing Hypertension in the Homeless using Health Information Technology

• Health information technology can play a crucial role in addressing hypertension in the homeless population by providing accessible and affordable healthcare solutions 2.
• Remote blood pressure monitoring combined with telehealth visits (RBPM) has been shown to be an effective strategy for controlling hypertension, especially in minoritized populations 2.
• The use of cellular-enabled blood pressure machines that do not require internet access or smart devices can help increase patient engagement and empowerment 2.
• Mobile health applications can also improve medication adherence in patients with hypertension, leading to better blood pressure control and overall health outcomes 3.
• Electronic medical records (EMRs) with clinical decision support (CDS) and performance feedback can help healthcare providers adhere to guideline-recommended care and improve blood pressure control in their patients 4.

Key Components of Effective Health Information Technology Interventions

• Multidisciplinary care teams that include nurses, pharmacists, and community health workers are essential for providing comprehensive care to patients with hypertension 2.
• Patient-generated health data, such as blood pressure readings and lifestyle behaviors, can be used to inform personalized care plans and improve patient outcomes 5.
• Integration of services to address social determinants of health (SDoH) is critical for reducing health disparities and improving health outcomes in vulnerable populations 2.
• Lifestyle interventions, such as regular physical exercise, body weight management, and healthy dietary patterns, can be effective in preventing and treating hypertension 6.

Challenges and Limitations

• Implementation of health information technology interventions can be challenging due to issues with technology adoption, patient engagement, and payment models 2.
• Current payment models may not support the digital components of RBPM or a diverse workforce of hypertension providers, highlighting the need for policy changes to support these interventions 2.
• Further research is needed to evaluate the effectiveness and scalability of health information technology interventions in addressing hypertension in the homeless population 5.