Thursday, June 26, 2008

Leveraging The Internet For Lower Blood Pressure

Information technology is an extremely important part of health care reform efforts in the modern age. The benefits of developing a wide ranging and compatible system of electronic health records has been shown in several studies to dramatically reduce the cost of administration, which accounts for a large percentage of spending.

Chronic conditions are also proven to consume a large share of medical spending, especially now that many Baby Boomers are reaching retirement age where these conditions often surface.

These two topics come together in a study from Wednesday's Journal of the American Medical Association, involving 778 Group Health patients with uncontrolled high blood pressure who were given the opportunity to have online assistance in managing their condition.

The results?

Via Time Magazine:

Among the more than 700 patients in the study, 258 were put into a standard physician-care group, with regular office visits. The remainder were divided into two self-care groups: in the first, patients had access to their electronic medical records and were instructed to measure their own blood pressure two to three times each week; patients then sent the results to their physician, who recorded the readings in files the patients could review. In the other group, patients performed the same self-measurements, but were also provided access to a pharmacist who evaluated their readings and helped patients adjust medication dosages as necessary. At the end of a year, twice as many people in the home-care-only group lowered their blood pressure to under 140/90 mmHg (the clinical cut-off for high blood pressure), compared with the standard-care group. But the patients with access to a pharmacist saw the most dramatic decline in blood pressure — a nearly 28-point lower measurement in the top number, or systolic reading, compared with the traditionally treated group. "We were surprised that the Web-based model had such a good effect, especially in those with more difficult-to-control hypertension," says lead author Dr. Beverly Green. "These people were three times more likely to get their blood pressure under control with the help of the pharmacist than those in the standard-care group."
This is big news. Not only does the study show that this approach is a step forward as far as effectiveness goes, but it also underscores the cost reduction that Internet technology can provide by reducing the costs incurred by multiple office visits. This is far from an instant cure-all, however; the "pay per visit" baseline of our health care system does not make this a profitable venture for care providers outside of Group-Health type plans. What it does do is pave the way more more innovative approaches as we evolve our idea of what truly American universal health care should be.

SOURCE: "Lowering Your Own Blood Pressure" 06/24/08
photo courtesy of skyfaller used under its Creative Commons license

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