An independent study by the Peterson Health Technology Institute has revealed that digital solutions for managing hypertension—especially those focused on medication management—can deliver rapid and clinically meaningful improvements in blood pressure that outperform traditional care.
The report also showed that other digital tools that focus only on changing patient behavior or sending home-monitoring data to doctors don’t deliver the same strong results. One of the top performers in this area, as detailed in the report, is Ochsner Digital Medicine, which uses a platform that combines current technology and team-based care to improve health outcomes. About 30,000 patients are now using Ochsner’s digital program, and more than 43,000 patients have been treated with its help since it was created about 10 years ago.
Metabolic conditions such as hypertension have been increasing steadily, now affecting nearly half of the adult population in the U.S. Despite its prevalence, effective management remains a challenge, largely due to inconsistent patient monitoring and limited access to health care resources. The rise of digital health solutions has promised to address these gaps by facilitating home monitoring and providing remote care options. However, as the Peterson study revealed, not all digital solutions are created equal.
“Digital hypertension management solutions that use the Medication Management approach deliver clinically meaningful decreases in systolic blood pressure relative to usual care, and they bring a greater proportion of patients into blood pressure control than usual care. These solutions also support faster improvements in hypertension than what typically occurs under usual care,” says the study.
Ochsner Digital Medicine is a part of Ochsner Health—a member of the AMA Health System Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Meeting a growing need
Over 10 years ago, Ochsner Health began its journey in digital health with the establishment of Innovation Ochsner. The initiative aimed to leverage technology to improve health care delivery and outcomes, particularly for chronic conditions such as hypertension.
Dan Shields, CEO of Ochsner Digital Medicine, said that the original goal was to address the increasing challenges of managing chronic conditions in an environment marked by physician shortages and growing patient demand.
“We already believed strongly in value-based care, and we knew that patients in Louisiana and Mississippi particularly struggle with these conditions,” said Shields. “We realized that as a health system, we are going to be judged more by our outcomes than by how many beds we fill or how much money we make, which is the correct standard. Everyone foresaw a shortage of physicians, but we see now that it’s probably far worse than we ever anticipated. We couldn’t just throw more people at these problems.”
By surveying physicians and other health professionals, Ochsner Health found that primary care physicians lacked enough data and were not supported well enough to effectively treat cardiometabolic conditions.
“We have been asking them to make clinical decisions when patients come in to see them once or twice a year, if we're lucky,” said Shields. “Too many of their patients don't come in at all. Those one or two visits just aren’t enough time to effectively address these conditions.”
Starting with remote-patient monitoring, Ochsner Health then took the findings from all the gathered data and added specialty teams of physicians and other health professionals to help better manage chronic conditions. Through this program, patients are equipped with devices that collect blood pressure readings, which are transmitted directly into their EHR. This allows physicians to analyze the data and adjust medication dosages as needed in real time.
Specialized care teams, supported by technology, are able to act quickly to modify treatment regimens and provide individualized support, ensuring patients receive the most appropriate care. And with specialists added to help cover chronic care, primary care doctors get some time back for additional patient needs.
In fact, a primary care physician would need an average of 7.2 hours per day just to focus on patients’ chronic diseases alone, according to a study published in the Journal of General Internal Medicine.
Ochsner Health’s digital program “helps reduce the burden and reduce burnout and increases access to care by freeing up doctors’ time,” Shields said. “We're using digital as a member of the team to help with physician burnout. Getting more patients the care they need through primary care can potentially help streamline access to specialists, and get patients paired sooner when needed. The hope is we can fix access issues upstream as well.”
From AI implementation to EHR adoption and usability, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors—not a burden.
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Improving BP control
Through this model, Ochsner Health has seen remarkable improvements in patient outcomes, particularly in blood pressure control.
On average, the 30,000 patients who are being treated with help from Ochsner Digital Medicine are submitting two readings per week. Following the data analyses and subsequent medication management decisions, 80% of patients achieve BP control in about six months, according to Shields. He added that 90% of patients using the platform actively have their blood pressure controlled at any given time.
“You go into a doctor’s office and have blood pressure taken at any particular time and it might be high, maybe a little low,” Shields said. “It changes so often that we really need to look at trends over time. That’s exactly what this technology does for us, and then decisions can be made about making a medication change when it’s needed.”
These outcomes are often promised by an array of app-based services for health care, but many haven’t yet been proven to meaningfully improve health. Ochsner Health had a dual benefit in creating this platform that tech-based startups don’t have: an employee population of about 30,000 with enough willing participants to test it, and the rigorous standards of an academic medical center whose first and foremost function is to treat patients effectively.
“Not just being a digital health company worked heavily in our favor,” Shields said. “We could offer it to our whole workforce of 30,000 and a startup maybe has a staff of 100. We actually didn’t make this a public facing program until we already knew it worked. Staff won't let me do anything until we've proven it works. So, we might move slower than a startup but by the time it gets out there to people we know it’s effective.”
By incorporating medication management into its digital health platform, Ochsner has not only achieved better clinical outcomes but also reduced health care expenditures by preventing complications and hospitalizations that often arise from poorly managed hypertension.
“We were pleased to see that the independent review came to the same conclusions we have,” Shields said. “Having a third party look at the data and validate our approach is incredibly rewarding. PHTI looked at an awful lot of data. This wasn’t a cursory review. To have an entity like that validate our work, it just reinforces that we’re on the right path.”
AMA MAP™ Hypertension is an evidence-based quality improvement program that provides a clear path to significant, sustained improvements in BP control. With the AMA MAP program, health care organizations can increase BP-control rates quickly. The program has demonstrated a 10% increase in BP control in six months with sustained results at one year.
Receiving patient and physician feedback
Ochsner Digital did employ a feedback approach often used by tech startups to gauge how well the program is faring for patients—net promoter score. This single-question survey usually asks respondents to rate the likelihood they would recommend a company, product or service. Ochsner Digital Medicine’s most recent net promoter score results from patients within the program was an 82. Benchmarks differ depending on which type of business or organization is surveying, but net promoter scores above 80 are considered to be world class.
In addition to the survey response, patients stay within the program for about two-and-a-half to three years. Meanwhile, some patients have been using the program for eight years, Shields said.
“It’s really designed to help people manage the condition continuously, rather than graduating from the program,” Shields said. “We found that patients who tried out six-to-eight-week coaching programs did well during but then regressed once they ended. As long as we can help people manage their conditions, we’ll keep going.”
Physicians have been vocal since the program was created about pain points along the way, and ways to improve the systems.
“We had very patient, very understanding, and very committed leadership saying, ‘We're going to make this work,’” Shields said. “Whereas I think other health systems might have gotten about four years in and shut it down because it wasn’t quite working. It was a lot of iteration, a lot of learning, and a lot of commitment to make it work.”
Learn more with the AMA Remote Patient Monitoring Playbook.
