SWOT-analysis: Remote monitoring of blood pressure

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Abstract

Global political and socioeconomic changes have caused a huge strain on the healthcare system. To transition into a new level of medical care, modern technological solutions are needed. Accelerated development of innovations in medicine and the formation of a personalized approach will improve the quality and accessibility of medical services. One of the directions of healthcare development is the use of digital technologies and remote monitoring in assessing the health indicators of citizens. Currently, the federal project of remote monitoring of patients with arterial hypertension, named, “Personal Medical Assistants,” is being implemented in the Russian Federation. Similar to any new technology, remote monitoring has advantages and disadvantages. In this article, a strategic analysis (SWOT-analysis) was performed, considering medical, economic, social, and political aspects that may affect the results of the federal project. For effective implementation of remote monitoring technology in clinical practice, the strengths and weaknesses in the healthcare system and the state as a whole must be emphasized. SWOT-analysis can be used in formulating strategies for the widespread use of new digital technologies in clinical practice.

About the authors

Alexandra E. Demkina

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Email: ademkina@bk.ru
SPIN-code: 4657-5501

MD, Cand. Sci (Medicine)

Russian Federation, Moscow

Anna N. Korobeynikova

Center of Cardiology and Neurology

Author for correspondence.
Email: anna_best2004@mail.ru
ORCID iD: 0000-0002-8934-7021
SPIN-code: 9728-9583

MD, Cand. Sci. (Medicine)

Russian Federation, Kirov

Anatoliy N. Rogoza

National Medical Research Centre of Cardiology Named After Academician E.I. Chazov

Email: anrogoza@gmail.com
ORCID iD: 0000-0002-4829-0954
SPIN-code: 9362-3496

Dr. Sci. (Biology), Professor

Russian Federation, Moscow

Anton V. Vladzimirskiy

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Email: a.vladzimirskiy@npcmr.ru
ORCID iD: 0000-0002-2990-7736
SPIN-code: 3602-7120

MD, Dr. Sci. (Medicine)

Russian Federation, Moscow

References

  1. Zudin AB, Chepin VO. Global Challenges for Russian Healthcare. Byulleten’ Natsional’nogo nauchno-issledovatel’skogo instituta obshchestvennogo zdorov’ya imeni N.A. Semashko. 2016;(5):41–45. (In Russ). EDN: XWOKVJ
  2. Boytsov SA, Demkina AE, Oshchepkova EV, Dolgusheva YuA. Progress and Problems of Practical Cardiology in Russia at the Present Stage. Kardiologiia. 2019;59(3):53–59. EDN: CJGCQF doi: 10.18087/cardio.2019.3.10242
  3. Boytsov SA, Pogosova NV, Bubnova MG, et al. Cardiovascular prevention 2017. National Guidelines. Russian Journal of Cardiology. 2018;23(6):7–122. EDN: XSLTTF doi: 10.15829/1560-4071-2018-6-7-122
  4. Balanova YuA, Shalnova SA, Imaeva AE, et al. Prevalence, Awareness, Treatment and Control of Hypertension in Russian Federation (Data of Observational ESSERF-2 Study). Rational Pharmacotherapy in Cardiology. 2019;15(4):450–466. EDN: ZRWESV doi: 10.20996/1819-6446-2019-15-4-450-466
  5. Lebedev GS, Vladzymyrskyy AV, Shaderkin IA, Dudareva VP. Remote monitoring complex for chronic noncommunicable diseases. Russian Journal of Telemedicine and E-Health. 2020;8(1):7–14. EDN: NMFKNG doi: 10.29188/2712-9217-2022-8-1-7-14
  6. Nikolaev VA. Innovative technologies for personalized medicine. Forcipe. 2019;2(S3):40–41. EDN: UEPRRX
  7. Bautista LE. Predictors of persistence with antihypertensive therapy: Results from the NHANES. Am J Hypertens. 2008;21(2):183–188. doi: 10.1038/ajh.2007.33
  8. Paramore LC, Halpern MT, Lapuerta P, et al. Impact of poorly controlled hypertension on health care resource utilization and cost. Am J Manag Care. 2001;7(4):89–98.
  9. Varma N, Epstein AE, Irimpen A, et al. TRUST investigators. Efficacy and safety of automatic remote monitoring for implantable cardioverter-defibrillator follow-up: the lumos-t safely reduces routine office device follow-up (TRUST) Trial. Circulation. 2010;122(4):325–332. doi: 10.1161/CIRCULATIONAHA.110.937409
  10. Sana F, Isselbacher EM, Singh JP, et al. Wearable Devices for Ambulatory Cardiac Monitoring: JACC State-of-the-Art Review. J Am CollCardiol. 2020;75(13):1582–1592. doi: 10.1016/j.jacc.2020.01.046
  11. Cleland JGF, Louis AA, Rigby AS, et al. Noninvasive home telemonitoring for patients with heart failure at high risk of recurrent admission and death: the Trans-European Network-Home-Care Management System (TEN-HMS) study. Journal of the American College of Cardiology. 2005;45(10):1654–1664. doi: 10.1016/j.jacc.2005.01.050
  12. Pyzhlakov DS. Strengths and Opportunities. The concept of dynamic SWOT analysis. Russian Journal of Entrepreneurship. 2008;(6-1):133–138. (In Russ). EDN: JKONSZ
  13. Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality. The Lancet. 2003;361(9366):1391–1392. doi: 10.1016/S0140-6736(03)13061-9
  14. Slimko ML, Mensah GA. The role of diets, food, and nutrients in the prevention and control of hypertension and prehypertension. Clinical Cardiology. 2010;4(28):665–674. doi: 10.1016/j.ccl.2010.08.001
  15. Chazova IE, Oshchepkova EV. Results of the federal (national) project for prevention and treatment essential hypertension patients in Russia from 2002–2012 years. Annals of the Russian academy of medical sciences. 2013;68(2):4–11. EDN: PWEBNT doi: 10.15690/vramn.v68i2.542
  16. McKoy J, Fitzner K, Margetts M, et al. Are telehealth technologies for hypertension care and self-management effective or simply risky and costly. Popul Health Manag. 2015;18(3):192–202. doi: 10.1089/pop.2014.0073
  17. Fitzner K, Moss G. Telehealth-an effective delivery method for diabetes self-management education. Popul Health Manag. 2013;16(3):169–177. doi: 10.1089/pop.2012.0054
  18. Flodgren G, Rachas A, Farmer AJ, Inzitari M, Shepperd S. Interactive telemedicine: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2015;2015(9):CD002098. doi: 10.1002/14651858.CD002098.pub2
  19. Piette JD, Marinec N, Gallegos-Cabriales EC, et al. Spanish-speaking patients’ engagement in interactive voice response (IVR) support calls for chronic disease self-management: data from three countries. Telemed Telecare. 2013;19(2):89–94. doi: 10.1177/1357633x13476234
  20. Kaambwa B, Bryan S, Jowett S, et al. Telemonitoring and self-management in the control of hypertension (TASMINH2): a cost-effectiveness analysis. Eur J Prev Cardiol. 2014;21(12):1517–1530. doi: 10.1177/2047487313501886
  21. Maciejewski ML, Bosworth HB, Olsen MK, et al. Do the benefits of participation in a hypertension self-management trial persist after patients resume usual care. Circ Cardiovasc Qual Outcomes. 2014;7(2):269–275. doi: 10.1161/CIRCOUTCOMES.113.000309
  22. Shaderkin IA, Shaderkina VA. Remote health monitoring: motivating patients. Journal of Telemedicine and E-Health. 2020;6(3):37–43. EDN: PBHHKX doi: 10.29188/2542-2413-2020-6-3-37-43
  23. Wise J. Activity trackers, even with cash incentives, do not improve health. BMJ. 2016;355:i5392. doi: 10.1136/bmj.i5392
  24. Jones MI, Greenfield SM, Bray EP, et al. Patients’ experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study. Br J Gen Pract. 2012;65(595):e135–e142. doi: 10.3399/bjgp12X625201
  25. Shaw RJ, Kaufman MA, Bosworth HB, et al. Organizational factors associated with readiness to implement and translate a primary care-based telemedicine behavioral program to improve blood pressure control: the HTN-IMPROVE study. Implement Sci. 2013;8. doi: 10.1186/1748-5908-8-106
  26. AbuDagga A, Resnick HE, Alwan M. Impact of Blood Pressure Telemonitoring on Hypertension Outcomes: A Literature Review. Telemedicine and eHealth. 2010;16(7):830–838. doi: 10.1089/tmj.2010.0015
  27. Chandak A, Joshi A. Self-management of hypertension using technology enabled interventions in primary care settings. Technology and Health Care. 2015;23(2):119–128. doi: 10.3233/thc-140886
  28. McKinstry B, Hanley J, Lewis S. Telemonitoring in the management of high blood pressure. Curr Pharm Des. 2015;21(6):823–827. doi: 10.2174/1381612820666141024154232
  29. Sivakumaran D, Earle K. Telemonitoring: use in the management of hypertension. Vascular Health and Risk Management. 2014;10:217–224. doi: 10.2147/vhrm.s36749
  30. Kontsevaya AV, Komkov DS, Boytsov SA. The modeling as a technique of evaluation of expediency of remote monitoring of arterial tension at the regional level. Health Care of the Russian Federation. 2017;61(1):10–16. EDN: YFOKVP doi: 10.18821/0044-197X-2017-61-1-10-16
  31. Ho K. Health-e-Apps: A project to encourage effective use of mobile health applications. BCMJ. 2013;55(10):458–460.
  32. Isaeva AV, Krasnova KS, Tagoev YuSh, et al. A study of the digital readiness of patients with chronic heart failure. Russian Journal of Preventive Medicine and Public Health. 2023;26(3):101–108. EDN: DGKTAU doi: 10.17116/profmed202326031101
  33. Baysangurov AF, Arutyunova NN, Baysangurova MM. Analysis of the demotivation factors that reduce the efficiency of employees. Digital Diagnostics. 2021;2(2S):10–11. EDN: VGEGJF doi: 10.17816/DD83175
  34. Davoudi A, Lee NS, Chivers C, et al. Patient interaction phenotypes with an automated remote hypertension monitoring program and their association with blood pressure control: observational study. J Med Internet Res. 2020;22(12):e22493. doi: 10.2196/22493
  35. Vandenberk T, Lanssens D, Storms V, et al. Relationship Between Adherence to Remote Monitoring and Patient Characteristics: observational study in women with pregnancy-induced hypertension. JMIR mHealth and uHealth. 2019;7(8):e12574. doi: 10.2196/12574
  36. Case MA, Burwick HA, Volpp KG, et al. Accuracy of smartphone applications and wearable devices for tracking physical activity data. JAMA. 2015;313(6):625–626. doi: 10.1001/jama.2014.17841
  37. O’Kane MJ. Efficacy of self-monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial. BMJ. 2008;336(7654):1174–1180. doi: 10.1136/bmj.39534.571644.BE
  38. Walker RC, Tong A, Howard K, et al. Patient expectations and experiences of remote monitoring for chronic diseases: Systematic review and thematic synthesis of qualitative studies. Int J Med Inform. 2019;124:78–85. doi: 10.1016/j.ijmedinf.2019.01.013
  39. Mareev YuV, Zinchenko AO, Myasnikov RP, et al. Telemonitoring in patients with chronic heart failure. Kardiologiia. 2019;59(S9):4–15. EDN: ISWIAY doi: 10.18087/cardio.n530
  40. Omboni S, Ferrari R. The role of telemedicine in hypertension management: focus on blood pressure telemonitoring. Curr Hypertens Rep. 2015;17. doi: 10.1007/s11906-015-0535-3
  41. Gazit T, Gutman M, Beatty AL. Assessment of hypertension control among adults participating in a mobile technology blood pressure self-management program. JAMA Netw Open. 2021;4(10):e2127008. doi: 10.1001/jamanetworkopen.2021.27008
  42. Komkov DS, Baturin DI, Kulikov AA, et al. The role of SMS-informing in the dispensary monitoring of patients with arterial hypertension. Arterial’naya Gipertenziya. 2015;21(S1):91. (In Russ). EDN: WEPXLT
  43. Komkov DS, Goryachkin EA, Korsunsky DV, et al. Clinical effectiveness of various models of telemedicine technologies in patients with arterial hypertension. Russian Journal of Preventive Medicine and Public Health. 2020;23(4):27–35. EDN: PMROKX doi: 10.17116/profmed20202304127
  44. Melnyk SD, Zullig LL, McCant F, et al. Telemedicine cardiovascular risk reduction in veterans. Am Heart J. 2013;165(4):501–508. doi: 10.1016/j.ahj.2012.08.005
  45. Kalinina AM, Gornyy BE, Dubovoy II, et al. The attitude of primary care physicians to the use of telemedicine technologies in dispensary observation of patients with chronic diseases (medical and sociological research). Russian Journal of Preventive Medicine and Public Health. 2020;23(6):8–13. EDN: TIADWK doi: 10.17116/profmed2020230628
  46. Wang V, Smith VA, Bosworth HB, et al. Economic evaluation of telephone self-management interventions for blood pressure control. Am Heart J. 2012;163(6):980–986. doi: 10.1016/j.ahj.2012.03.016
  47. Cuspidi C, Facchetti R, Dell’Oro R, et al. Office and out-of-office blood pressure changes over a quarter of century: findings from the PAMELA Study. Hypertension. 2020;76(3):759–765. doi: 10.1161/HYPERTENSIONAHA.120.15434
  48. Mancia G, Facchetti R, Bombelli M, et al. Long-term risk of mortality associated with selective and combined elevation in office, home, and ambulatory blood pressure. Hypertension. 2006;47(5):846–853. doi: 10.1161/01.HYP.0000215363.69793.bb
  49. Stergiou GS, Salgami EV, Tzamouranis DG, Roussias LG. Masked hypertension assessed by ambulatory blood pressure versus home blood pressure monitoring: is it the same phenomenon. Am J Hypertens. 2005;18(6):772–778. doi: 10.1016/j.amjhyper.2005.01.003
  50. Pickering TG. Self-monitoring of blood pressure. In: Ambulatory Monitoring and Blood Pressure Variability (Part 1). London: Science Press; 1990.
  51. Pickering T. Recommendations for the use of home (self) and ambulatory blood pressure monitoring. American Society of Hypertension Ad Hoc Panel. Am J Hypertens. 1996;9(1):1–11. doi: 10.1016/0895-7061(95)00341-x
  52. Barochiner J, Posadas Martínez ML, Martínez R. Reproducibility of masked uncontrolled hypertension detected through home blood pressure monitoring. J Clin Hypertens (Greenwich). 2019;21(7):877–883. doi: 10.1111/jch.13596
  53. Myers MG. Reporting bias in self-measurement of blood pressure. Blood Press Monit. 2001;(6):181–183.
  54. Miao H, Liu Y, Tsai TC, Schwartz J, Ji JS. Association between blood lead level and uncontrolled hypertension in the US population (NHANES 1999-2016). J Am Heart Assoc. 2020;9(13):e015533. doi: 10.1161/JAHA.119.015533
  55. Jackson SL, Gillespie C, Shimbo D, Rakotz M, Wall HK. Blood Pressure Cuff Sizes for Adults in the United States: National Health and Nutrition Examination Survey, 2015–2020. Am J Hypertens. 2022;35(11):923–928. doi: 10.1093/ajh/hpac104
  56. Cepeda M, Pham P, Shimbo D. Status of ambulatory blood pressure monitoring and home blood pressure monitoring for the diagnosis and management of hypertension in the US: an up-to-date review. Hypertens Res. 2023;46:620–629. doi: 10.1038/s41440-022-01137-2
  57. Duan Y, Xie Z, Dong F, et al. Effectiveness of home blood pressure telemonitoring: a systematic review and meta-analysis of randomised controlled studies. Journal of Human Hypertension. 2017;31:427–437. doi: 10.1038/jhh.2016.99
  58. Bubnova MG, Tribuntseva LV, Ostroushko NI, et al. Impact of remote follow-up on the course of hypertension. The Russian Journal of Preventive Medicine. 2018;21(5):77–82. EDN: YPHTZJ doi: 10.17116/profmed20182105177
  59. Schoenhagen P, Mehta N. Big data, smart computer systems, and doctor-patient relationship. European Heart Journal. 2017;38(7):508–510. doi: 10.1093/eurheartj/ehw217
  60. Sharova DE, Zinchenko VV, Akhmad ES, et al. On the issue of ethical aspects of the artificial intelligence systems implementation in healthcare. Digital Diagnostics. 2021;2(3):356−368. EDN: TGZGZZ doi: 10.17816/DD77446
  61. Kario K, Tomitani N, Kanegae H, et al. The further development of out-of-office BP monitoring: Japan’s ImPACT Program Project’s achievements, impact, and direction. J Clin Hypertens (Greenwich). 2019;21(3):344–349. doi: 10.1111/jch.13495
  62. Starodubtseva IA, Sharapova YuA. The Distance Monitoring of Blood Pressure as a Tool for Improving of the Quality of Follow-Up Observation of Patients with Arterial Hypertension. The Russian Archives of Internal Medicine. 2021;11(4):255–263. EDN: FTKKTE doi: 10.20514/2226-6704-2021-11-4-255-263
  63. Karpov OE, Khramov AE. Information Technology, Computing and Artificial Intelligence in Medicine. Moscow: DPK Press; 2022. (In Russ).
  64. Buldakova TI, Mikov DA, Sokolova AV. Data Security at Remote Monitoring of Human State. Herald of the Bauman Moscow state technical university. Series Instrument engineering. 2020;(4):42–57. EDN: QHBUUF doi: 10.18698/0236-3933-2020-4-42-57
  65. Alessa T, Hawley MS, Hock ES, de Witte L. Smartphone apps to support self-management of hypertension: review and content analysis. JMIR mHealth and uHealth. 2019;7(5):e13645. doi: 10.2196/13645
  66. Picone DS, Deshpande RA, Schultz MG, et al. Nonvalidated home blood pressure devices dominate the online marketplace in Australia. Hypertension. 2020;75(6):1593–1599. doi: 10.1161/HYPERTENSIONAHA.120.14719
  67. Jalali MS, Russell B, Razak S, et al. EARS to cyber incidents in health care. J Am Med Inform Assoc. 2019;26(1):81–90. doi: 10.1093/jamia/ocy148
  68. Vladzymyrskyy AV. Systematic review: the messengers «WhatsApp®» and «Viber®» in a clinical routine. Zhurnal telemeditsiny i elektronnogo zdravookhraneniya. 2017;(1):30–41. EDN: YPTUYR

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