With glaring racial disparities in maternal mortality, a program that could begin to bridge gaps in postpartum care was desperately needed.
In April 2020, the start of the pandemic, Christina Yarrington, MD, FACOG, director of labor and delivery at Boston Medical Center knew that in order to address the approximately 30% of patients who manage hypertensive issues during their pregnancies, she needed to think creatively. So, she and her team launched a high-tech home blood pressure monitoring program. They provided postpartum patients with easy-to-use blood pressure cuffs to monitor their blood pressure at home. Using cellular-enabled technology, these cuffs can capture readings with one touch, encrypt vitals, and send data to a HIPAA-compliant web portal using the local cell phone network. Patients using the device do not need a cellphone, data plan, or any additional interfacing.
Prior to their remote monitoring program, only 13% of these high-risk patients were in compliance with the American College of Obstetrics and Gynecology’s guidelines of a blood pressure check within 7 to 10 days postpartum. In the newest phase of the program, 79% of patients had at least one recorded blood pressure measure in that window, and it increased to 91% when you expanded the window plus or minus two days.
Capturing these blood pressures allows them to intervene and start medications when necessary, and they have also have seen rates of hypertension drop since the program began. Before implementation, the rate of severe range hypertension was 18.4% among patients who would have met the eligibility criteria for the blood pressure monitoring program. After, the rate significantly dropped to 5.9%, that’s less than half the published rate from other studies that have done remote blood pressure monitoring without the intensive treatment.