Evaluation of a Telehealth Hypertension Management Program

Abstract

Purpose: The purpose of this project is to describe and evaluate how the nurse practitioners’ role impact the hypertension (HTN) management for the veteran population, ages 20-64 years, who enrolled in the Phoenix VA Health Care System-Home Telehealth (PVAHCS-HT) program.Background: Uncontrolled HTN increases morbidity and mortality risks associated with cardiovascular diseases. Cardiovascular conditions are prevalent among the veteran population. Several studies support the efficacy of remote patient monitoring in reducing high blood pressure. The PVAHCS- HT program is a virtual care delivery model that optimizes HTN management through remote biometric monitoring and intervention. The role of NPs as HT care providers is a model exclusive to the PVAHCS. The NP role has not been evaluated for its impact on HTN management since program implementation in 2015. Methods: This DNP project, guided by the Centers for Disease Control and Prevention Framework for Program Evaluation in Public Health, is a descriptive program evaluation involving retrospective data collection and analysis from the Computerized Patient Record System (CPRS) and Medtronic® Omnivisor Pro. Sampling was based on a set of predetermined inclusion-exclusion criteria. The program evaluation includes 16 veterans who participated in HT between January 1 to March 31, 2021. Excel® Pivot table and statistical functions were used for data analysis to describe the impact of HT and NP role on blood pressure (BP) outcomes. Additionally, a multisite Community-Based Outpatient Clinics (CBOC) survey used Google® Form and Sheets to describe the non-HT providers’ awareness, use, and satisfaction with the program. Results: The NP role shows a positive impact on BP reduction. The frequency of monitoring has no association with BP outcome, while shorter time to treatment intervention shows positive correlation with BP outcome. Additionally, the survey conducted convey overall positive program approval in terms of awareness, utilization, and satisfaction. Conclusions: The project results support the NP role in the PVAHCS-HT program and aligns with the HT and PVAHCS goals as evidenced by the survey results showing familiarity and use of the HT. Continued program evaluation is needed to develop HT sustainability strategies to maintain program value for the veteran population it serves.