Patient Utilization of Remote Patient Monitoring in a Pilot Implementation at a Federally Qualified Health Center.
Academic Article
Overview
abstract
Objective: This study aimed to explore the effects of demographics and social determinants of health (SDOH) on remote patient monitoring (RPM) utilization and blood pressure (BP) improvement. Methods: A secondary data analysis of an RPM program for hypertension in federally qualified health centers (FQHCs). This observational study, guided by the Digital Health Equity-focused Implementation Research framework (DH-EquIR), used linear mixed effect models to investigate the effects of demographics and mean area deprivation index (ADI) on utilization and BP change among patients with three months of home BP monitoring data. Utilization was measured as a count of missed days per week, indicating days without transmitted BP readings. Results: There were 105 participants, averaging 55.4 years old, with 64.8% Black or African American race, and 33.4% of Hispanic/Latino ethnicity. On a scale of 1-10, with 1 indicating the lowest level of deprivation, the mean ADI NY state rank was 3.3. As weeks on RPM progressed, participants experienced significant increases in missed days per week overall. For every point increase in ADI NY state rank, missed days per week increased by 0.24 (p < 0.05). Regardless of ADI, for every increasing week on RPM, the systolic BP value decreased by 0.55 mmHg (p < 0.0001). Conclusion: This DH-EquIR-guided RPM study, among the first in FQHCs, found minimal RPM usage differences by demographics and SDOH. Overall, participants in this sample effectively utilized RPM and showed improvement in BP, including in participants living in areas of high ADI NY state rank and inconsistent RPM utilization.
