There has been a rapid increase in the use of telehealth services by many health systems, organizations and medical practices since the COVID-19 pandemic began. By using self-measured blood pressure (SMBP) monitoring, physicians and other health professionals can help patients with hypertension achieve and maintain their BP goals, whether care is delivered in-person or using telehealth.
To help physicians and care teams implement SMBP, the AMA has created a seven-step SMBP quick guide. This evidence-based resource includes links to practical implementation tools as well as information about ensuring accuracy of SMBP, how to interpret SMBP measurements and details about CPT codes that can be submitted for SMBP services. The quick guide content is available to all physicians and health systems as part of the AMA’s efforts to improve BP control.
“SMBP can help enhance the quality and accessibility of care, whether you’re seeing patients with hypertension in-person or via telemedicine,” said Neha Sachdev, MD, a family physician and director of health systems relationships at the AMA. “The quick guide was created to assist physicians and care teams with using SMBP in their practice.”
Here are the seven steps physicians and other health professionals can follow to start using SMBP.
Identify patients for SMBP
To begin, physicians and other health professionals need to identify patients for SMBP. These can be patients in whom a diagnosis of hypertension needs to be confirmed or patients already diagnosed with hypertension.
In a recent episode of the “AMA COVID-19 Update,” experts share how to help patients manage high blood pressure remotely.
Confirm device validation and cuff size
It is important for physicians and care teams to make sure patients use an automated and validated upper arm BP measurement device with an appropriately sized cuff for SMBP.
Learn more from the AMA about a project that aims to validate clinical accuracy of BP measurement devices.
Train patients to measure BP
Teaching patients to perform SMBP is an essential step for physicians and care teams. Education should include proper preparation and positioning to take BP measurements. It’s also helpful to verify patients’ understanding and share educational resources.
Tools that are available to help care teams educate patients include an SMBP training video and infographic, which are both available in English and Spanish.
Have patients perform SMBP
Physicians and care teams should provide instructions to patients on how often measurements should be taken and for how long. Seven days of SMBP monitoring is optimal, with measurements taken twice daily, once in the morning and once in the evening. Two measurements should be taken each time, with one minute of rest in between.
Average the results
Once SMBP measurements are received back from patients, the average systolic and diastolic BP should be calculated and documented. These averages should be used for clinical decision making.
The quick guide provides a SMBP averaging tool to help physicians and other health professionals.
Interpret patient measurements
Once measurements have been averaged and documented, physicians can interpret the results and initiate, intensify or continue BP treatment as needed. Because out of office BP measurements may be interpreted differently than in-office, the quick guide provides tables and information on interpreting and using SMBP measurements for diagnosis and treatment.
Document plans and communicate with patients
Physicians and other health professionals should also document treatment and follow-up plans, which should be communicated with their patients. The care team should also confirm the patient’s agreement and understanding of treatment. The quick guide resource also contains information about CPT codes that support the use of SMBP and went into effect in 2020, as well as information about CPT codes for remote physiologic monitoring.
“SMBP enables physicians and care teams to better diagnose and manage patients with hypertension. It is also a great way to engage patients,” said Dr. Sachdev. “It gives patients the opportunity to self-manage their blood pressure and actively participate in their care.”
Learn more from the AMA about how to code for SMBP during the pandemic.