Division of Cardiology (S.G.L.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Division of Endocrinology, Diabetes and Hypertension (N.D.L.F.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Hypertension. 2023 May;80(5):945-955. doi: 10.1161/HYPERTENSIONAHA.122.19436. Epub 2023 Mar 2.
We stand at a critical juncture in the delivery of health care for hypertension. Blood pressure control rates have stagnated, and traditional health care is failing. Fortunately, hypertension is exceptionally well-suited to remote management, and innovative digital solutions are proliferating. Early strategies arose with the spread of digital medicine, long before the COVID-19 pandemic forced lasting changes to the way medicine is practiced. Highlighting one contemporary example, this review explores salient features of remote management hypertensive programs, including: an automated algorithm to guide clinical decisions, home (as opposed to office) blood pressure measurements, an interdisciplinary care team, and robust information technology and analytics. Dozens of emerging hypertension management solutions are contributing to a highly fragmented and competitive landscape. Beyond viability, profit and scalability are critical. We explore the challenges impeding large-scale acceptance of these programs and conclude with a hopeful look to the future when remote hypertension care will have dramatic impact on global cardiovascular health.
我们正处于高血压医疗服务的关键时刻。血压控制率停滞不前,传统医疗服务正在失效。幸运的是,高血压非常适合远程管理,创新的数字解决方案正在涌现。早在 COVID-19 大流行迫使医学实践方式发生持久改变之前,随着数字医学的传播,早期策略就已经出现。本文以一个当代的例子为例,探讨了远程管理高血压计划的显著特征,包括:指导临床决策的自动化算法、家庭(而非办公室)血压测量、跨学科护理团队以及强大的信息技术和分析。数十种新兴的高血压管理解决方案正在形成一个高度分散和竞争激烈的领域。除了可行性,盈利和可扩展性至关重要。我们探讨了阻碍这些项目大规模接受的挑战,并对远程高血压护理将对全球心血管健康产生重大影响的未来充满希望。