• Thousands of women and babies get very sick each year from hypertensive pregnancy disorders such as preeclampsia, which can also occur in the days or weeks following delivery. A team at the University of Pennsylvania Perelman School of Medicine is harnessing the convenience of smartphones, wireless blood pressure monitoring technology, and electronic health records (EHRs) to more closely monitor the blood pressure of post-partum patients after they go home from the hospital.

    Still in its early stages, the project ultimately intends to show that tracking patients’ blood pressure in the first seven days following delivery—the time in which complications from high blood pressure in pregnancy are most likely to occur—can help identify health problems early and improve outcomes.

    Using Apple HealthKit, an iOS-based protocol that enables people to capture and share vital signs and other health data on their iPhones, patients in the project send blood pressure data taken with a wireless blood pressure device twice daily to Penn clinicians. They also see a nurse for a blood pressure check one week after delivery, which is the current standard of care at Penn Medicine for patients who have high blood pressure post-partum. Patients without iPhones can still report data through online tools, but the process isn’t as seamless as it is through the Apple Health app, according to the principal investigator, Chileshe Nkonde-Price, MD, MRCP, cardiologist and faculty at Penn Medicine Center for Healthcare Innovation.

    The data is fed into patients’ records in PennChart, an Epic Systems electronic health record used by Penn Medicine. The project currently is in the proof-of-concept phase. Researchers are gathering data on the characteristics of participating patients, whether the data is timely, and whether patients are compliant. Anecdotally, the project already is making a difference in patients’ health, said Nkonde-Price. One example:  Nkonde-Price received an EHR alert notifying her of a patient’s dangerously high blood pressure, prompting her to call the patient to advise that she immediately reach out to her treating physician. The patient was admitted to the hospital for treatment of post-partum preeclampsia, a very rare condition.

    “It’s very rare, but very bad things can happen,” said Nkonde-Price. “The patient felt as if she would have stayed at home longer if she had not been in the trial, pushing off her headache and visual symptoms just from being overwhelmed and exhausted.”

    This is the first in a series of stories on NQF’s website that will look at innovations to capture data and measurement to improve healthcare.

 
 
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