Seeing his doctor less often has done wonders for Brad Reed’s blood pressure. That’s exactly what Ochsner Health System had in mind.
Reed is one of hundreds of Baton Rouge Ochsner patients and among more than 3,000 statewide who participate in remote monitoring digital medicine programs treating hypertension, diabetes and pregnancy. The programs, which began in New Orleans in 2014, allow providers to more quickly manage chronic medical issues while making it more convenient for the patient.
Digital medicine is, Ochsner says, a 21st-century approach that is going to continue to grow.
“We recognized that there was a real need to rethink the way that we care for patients, particularly those with chronic disease,” said Aimee Quirk, CEO of Innovation Ochsner, which was created three years ago to find ways to connect technology to medicine.
“We have such a high prevalence of people with chronic disease,” Quirk said. “Chronic disease is a big issue for our whole country. Seventy-five percent of the deaths and 86 percent of health care costs are from chronic disease, yet the country has not really figured out a way to crack that nut and make it better.”
Instead of office visits, patients use Bluetooth-enabled monitoring devices that connect through a smartphone app to send information to their electronic medical records. Ochsner has a technology center, named O Bar, at several locations providing the hardware, and technicians help patients know what they need and how to download and use it.
Patients whose blood pressure and diabetes are out of control are assigned a care team that includes their physicians and a clinical pharmacist and health coach. Patients conduct measurements as prescribed — or more often, if they want. If readings remain unhealthy, the pharmacist can recommend a medication change to the doctor, who has the last word. The health coach gives advice on lifestyle choices like diet and exercise.
Significant improvements are often seen within 90 days, Quirk said.
Reed, 50, was diagnosed with high blood pressure two years ago, reaching as high as 170/120. Initially prescribed 10 milligrams of fosinopril, the dosage had been increased to 40 mg, plus a diuretic, he said.
Since he began the remote monitoring program a little over a year ago, Reed said he has followed his health coach’s diet and exercise recommendations, and he measures his blood pressure daily. The readings have dropped, and his medicine dosage has been cut in half.
“It’s not where I want it, but it’s a lot better than it was,” Reed said.
Several components make the program successful, said Dr. Tiffany Davis, a family physician at Ochsner’s O’Neal Lane location. Health care providers get timely and accurate information. Patients regularly measuring blood pressure or blood glucose become more engaged in improving their health. Home monitoring eliminates the inconvenience of office visits.
“If you put it all together, it’s a home run,” Davis said.
Ochsner’s Connected MOM program enables pregnant women to remotely send blood pressure, weight and urine sample readings to their obstetricians. Expectant mothers get wireless scales, a blood pressure cuff and strips that detect how much protein is in their urine, all of which may help detect pre-eclampsia, said Dr. Ralph Dauterive, an OB-GYN at Ochsner’s O’Neal and Summa locations.
The biggest benefit to moms is convenience. The program cuts three or four office visits, Dauterive said, some of them later in pregnancy.
“Some of the visits we have people come to the clinic for really are just weight, blood pressure, answer a couple of questions,” Dauterive said. “They look at some of those visits and go, ‘Why did I have to spend two hours or take off from work or find a babysitter … and all you do is ask me how I’m doing and take my blood pressure?’
“Home blood pressure monitoring is the way to be checking blood pressure. Having people drive through Baton Rouge traffic to come have their blood pressure checked is going to increase your diagnosis of hypertension.”
Patients in the program pay only extra for the cost of the connected devices, which are under $40, Quirk said. The apps are free. Although reimbursement models usually exist before new care models are developed, Quirk said Ochsner decided to invest in digital infrastructure and technology and will figure out the business model along the way.
“We think it provides superior outcomes,” Quirk said. “Patients really like it because it’s convenient on their schedule, and we think it’s something that will help us because we can … help us help patients avoid adverse events. I think you will see more interest in these types of programs.”