Transforming Hypertension Care: A Journey with Parkland Health’s Care at Home Initiative

Almost half of U.S. adults, estimated at 119.9 million individuals, have hypertension, according to data from the Department of Health and Human Services (HHS). Only about a quarter of these adults, totalling 27.0 million, manage to keep their hypertension under control. 

In response to this pressing health concern, Parkland Health, a renowned safety-net hospital in Dallas County, is transforming care and improving the outcomes of patients with uncontrolled hypertension through its Hypertension Remote Patient Monitoring (RPM) program. 

At the 2023 This Way Home event, Sentayehu Kassa, MD, Associate Medical Director and Deputy Medical Information Officer, and Reagan Power, BSN, RN, CCRN, Nurse Navigator, shared about the great results Parkland is seeing from this model, the challenges they have overcome, and their expansion plans.  

Identifying the need for care at home

The journey toward implementing the Hypertension RPM program began with a commitment to address healthcare gaps and disparities in Dallas County. Parkland identified six underserved zip codes, laying the foundation for eight initial targeted initiatives with hypertension emerging as a focal point. 

Anticipated outcomes

System benefits

• Reduce unnecessary urgent care, emergency department visits, and hospital admissions. 
• Generate cost savings through proper utilization.
• Address wait times for primary care provider (PCP) appointments. 

Patient care

• Improve continuity of care, patient engagement, and satisfaction. 
• Increase opportunities for ongoing education and engagement. 
• Improve clinical outcomes by providing more support for controlling blood pressure

Provider benefits

• Increased communication between the patient and the medical team. 
• Increased opportunity to intervene early before acute exacerbation of chronic illnesses. 
• Improve staff and clinician satisfaction. 

Program Components

Parkland chose Current Health’s care-at-home technology for remote monitoring and engagement with its hypertension patients. To bridge literacy gaps and address transportation barriers, the team incorporated an initial in-person onboarding class to teach the patients how and why to use the technology to enhance engagement in ongoing management of chronic conditions. Patients then receive routine virtual visits to monitor blood pressure trends, assess general health, and reinforce medication adherence with ongoing education about lifestyle factors and community resources.

Results

With a keen focus on reducing emergency department visits and hospital admissions, the team has seen encouraging results so far – Patients, once burdened by uncontrolled hypertension, found themselves educated, engaged, and empowered to manage their health effectively. 

“It was a win-win to everyone – to patients, to the staff, physicians as well… We focus on high-risk patients. We wanted to reduce ED visits and hospital admissions and we have done that. Also, that’s a system wide cost reduction. It’s not only reducing unnecessary visits for patients, it means that by improving their care, we can reduce heart attack, stroke, complications in general, and we can improve their life.”

Sentayehu Kassa, MD  

Scaling for tomorrow

With plans to leverage AI for patient identification and referral system enhancements, the goal is to make this transformative care accessible to a broader population. The success of this initiative has laid the groundwork for the expansion into congestive heart failure, diabetes, and cardiac rehab.