The benefits of moving from manual vitals measurements to digital.
By Pete Mercer
It’s a staple of every doctor’s visit. Whether it’s a primary care physician, eye doctor, or dentist, someone will be on hand to take a patient’s blood pressure. Yet there is a significant population of patients that aren’t getting proper blood pressure measurements due to improper timing, tools, and/or technique from the provider. For physicians looking to improve the accuracy and workflow of collecting patient vitals, switching from manual tools to digital tools will allow them to streamline workflows and improve patient care.
As cases of hypertension continue to rise in both adult and pediatric patients, it’s more important than ever to get accurate blood pressure measurements for the patient. In addition to recording inaccurate blood pressure readings, taking manual blood pressure measurements can impact the physician workflow. When it comes to proper blood pressure measurement technique, timing is everything. According to the American Heart Association (AHA) guidelines, it is recommended that clinicians should average several readings, with rest periods in between, and repeat over 2-3 office visits.1,2 This is a significant challenge for patient care in a time where staffing shortages create a strain on an already challenging healthcare environment, which can lead to further misdiagnosis and inadequate treatment for the patient.
Getting the right measurements
The COVID-19 pandemic demonstrated the importance of measuring vital signs like temperature, oxygen saturation, and blood pressure to get a better picture of the health of the patient. While there are obvious benefits and improvements to patient care workflow efficiency, it is also much more cost effective and accurate for the practitioner to measure the necessary vitals at one time with one automated device.
There are plenty of factors to consider when taking vitals like blood pressure. For many, blood pressure can be elevated just by walking into a doctor’s office – a phenomenon called “white coat hypertension,” which affects up to 35% of patients.1,3 Even if the patient isn’t experiencing white coat hypertension, they can trip up their vitals simply by talking to another person, not resting for a few minutes, or if the cuff is not the right size.
Clinician error is another huge factor here, especially in the wake of staffing shortages and high levels of burnout in the healthcare industry, but accurate blood pressure measurement requires proper technique. Clinicians have a full plate when it comes to patient care, and something as routine as measuring blood pressure can be left to the wayside for patients that have other needs. Technique is still necessary in accurate measurement, which is why the simplicity of implementing a digital tool can have such an impact.
There are two main components for accurately measuring blood pressure in a modern outpatient office – automated blood pressure devices and averaging measurements. Using oscillometric devices, or automated blood pressure, physicians can take an accurate blood pressure measurement and reduce human error associated with instruments like stethoscopes. When physicians use these devices and average out several blood pressure readings, it increases the probability for a much more accurate blood pressure reading while following AHA recommendations.
One of the challenges that physicians are facing in diagnosing hypertension and high blood pressure is in the way that this data is being collected. The majority of outpatient offices are still using manual blood pressure cuffs, and one study shows that 95.1% of patients during the manual measurement period only had one blood pressure reading – potentially leading to inaccurate results or a misdiagnosis of hypertension.4
Implementing the proper tools
Finding the right solution is a critical part of this equation. Devices like the Welch Allyn Spot Vital Signs 4400 device and Connex Spot Monitor provide an all-in-one automated vitals solution that have been proven to take accurate vitals measurements. Both devices are also capable of taking multiple blood pressure readings and averaging them to obtain the most accurate blood pressure measurement per the American Heart Association guidelines. And the option of connectivity with a facility’s EMR (Electronic Medical Record), further helps to ensure the vitals documentation process is simple, fast and accurate.
The difference between an automatic and manual tool for reading patient vitals is significant. In addition to saving time, digital tools can include features to help support the diagnosis and treatment decisions of the physician.
One of the main hurdles for an investment in digital tools is the price point. It can be hard to justify what might seem like an unnecessary expenditure – especially when the manual tools have been used for so long. This mentality of “if it isn’t broken, don’t fix it” is an easy trap for healthcare organizations that are looking to cut costs wherever possible as well as the time and energy in reworking an existing workflow.
As distributor representatives, you can point out that blood pressure measurements are far too important to let a higher price point dictate this decision for providers. In fact, studies have shown that the time these devices save physicians can save them money in the long run. Baxter conducted a study5 that found that the average medical assistant cost of measuring a single blood pressure using a manual tool was $0.35, while the cost for a digital tool was $0.24 – a savings of $0.11 per reading. Once the medical assistant mastered using the digital tool, the savings jumped to $0.17 per reading. While saving $0.17 might not seem like very much, it can add up for a typical primary care practice. Using a digital tool can result in about $1,000 in savings per year using a Welch Allyn digital blood pressure measuring device.6
At a time when primary care is facing challenges at every level of every visit, it’s hard to ignore the implications of saving providers time and money, while also drastically improving their patient care processes. With the right timing, tools, and technique any practice can manage this chronic disease that impacts almost half of the U.S. adult population.
Editor’s note: Repertoire would like to thank Baxter for its contribution to this article. Learn more about the topic at hillrom.com/hypertension or call a Baxter representative today.
Baxter, Connex, Hillrom, Spot Vital Signs are trademarks of Baxter International Inc.
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Sources:
1. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018; 71: e127-248. DOI: 10.1016/j.jacc.2017.11.006
2. Muntner P, Shimbo D, Carey RM, et al. Measurement of blood pressure in humans. A scientific statement from the American Heart Association. Hypertension 2019; 73: e35-e66. DOI: 10.1161/HYP.0000000000000087
3. Gorostidi M, Vinyoles E, Banegas JR, de la Sierra A. Prevalence of white-coat and masked hypertension in national and international registries. Hypertens Res 2015; 38: 1-7. DOI: 10.1038/hr.2014.149
4. Kottke TE, Anderson JP, Zillhardt JD, et al. Association of an Automated Blood Pressure Measurement Quality Improvement Program With Terminal Digit Preference and Recorded Mean Blood Pressure in 11 Clinics. JAMA Netw Open. 2022;5(8):e2229098. doi:10.1001/jamanetworkopen.2022.29098
5. Yarows SA. What is the Cost of Measuring a Blood Pressure? Ann Clin Hypertens. 2018; 2: 059-066. DOI: 10.29328/journal.ach.1001012
6. Welch Allyn. Vital Considerations: Automatic Blood Pressure Devices Can Deliver Long-Term Benefits in Primary Care. 2020.