Breaking the Visit – collecting health data before and after in person clinical visits

Dr. Daniel Pepe, OntarioMD Physician Peer Leader

The Covid-19 pandemic has challenged us in so many ways. 

One major change we have seen within our own office is that seeing patients routinely for hypertension or diabetes has become less frequent than in the past. Specifically, due to fluctuation restrictions and lockdowns our ability to see patients reliably covid-19 has forced us to improve the way we work with patients to collect important health data.

One important data point for most clinicians is to measure a patient’s blood pressure. The prototypical illnesses where routine blood pressure measurements are important include diabetes and hypertension. Ensuring patients blood pressure is at target over time allows us to limit the risk of end organ damage such as retinopathy, nephropathy, peripheral vascular disease and aortic aneurysms. 

So how does it work? 

Like any digital initiative it is important to realize that this will not work for all patients. We need to carefully consider a patient’s personal preference, their literacy, access to broadband internet, and ability to measure home blood pressure and input values. Lastly, it is important to always share patient centered resources to help patients pick & find a blood pressure cuff that works well for them. 

Once you’ve identified that a patient is willing to measure and share their blood pressure with you the next item that needs to be determined is the reporting interval. Within my own practice this is dependent upon the patient’s control of blood pressure and can range from daily readings if the pressure is quite high to weekly, bi-weekly or monthly. Similar to INR management which has traditionally been managed by primary care providers this asynchronous blood pressure management can ensure that patients reach target more quickly and poorly controlled blood pressure can be optimized. 

In our own office, we utilize a patient portal and provide a simple message to patients to show them how to submit their values below

Dear Darren,

Thank you for agreeing to submit your blood pressures to the office! As a quick reminder when sending your blood pressure measurements please try to submit them in this format!

BP: 120/80

HR: 77


Dr. Pepe 

So Where is the value? 

Have a look at the data below from one patient who made the decision to move from measuring blood pressure only during diabetic visits to reporting their blood pressure weekly through a portal. Clearly now we can see that the patient’s blood pressure is at target more often and leaves us with more clarity to help make an informed decision. Most importantly, sharing this type of data with patients provides an opportunity to help them to become engaged in self-management of their illness. 

This Post Has 2 Comments

  1. Randy Filinski

    This is a very encouraging article that exemplifies self management and choice to the patient with a basic portal. You also seem clear that it is not for all and that is an important consideration.

    I have great docs but no portal other than to schedule an appointment but Primary Care needs to break-out and extend their trusted value.

  2. Dan Pepe

    Thanks Randy! Greatly appreciate your comments!
    We do need to help primary care grow and continue to expand

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