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At least two national companies currently provide blood pressure telemonitoring services.

 

LifeLink Monitoring, Inc., 751 Grant Avenue, Lake Katrine, NY 12449, (888) 595-8080, http://www.llmi.com

 

This company supplies patients with a self-blood pressure monitor for home use and sets up an automated monitor-telephone connection. No equipment purchase is required. The monitor inflates the cuff automatically, deflates it, displays blood pressure and pulse readings, and stores them, along with time and date, in its memory. At regular intervals (as ordered by the patient's primary care provider, typically daily or weekly), the monitor sends the stored readings to the monitoring facility through a small interface device plugged into the patient's telephone line. The patient then picks up the telephone receiver and an interactive voice response system provides her with an average level for the readings just sent and congratulates her if she's at goal. The system can also ask patients questions about their symptoms and medication compliance.

 

The entire procedure requires the patient to press just one button and takes less than two minutes. Graphic and tabular reports of monitor data and patient responses to questions are almost immediately available to providers and patients on a secure Web site that is compliant with the Health Insurance Portability and Accountability Act of 1996. Data can also be delivered to a patient's electronic medical record. The service costs the patient about $50 to $60 per month (depending on volume), plus a one-time shipping and set-up fee of about $40. These fees cover outbound and return shipping to the patient, equipment usage, toll-free telephone service, live-agent customer service for patients and clinicians, and reports to clinicians. There are no other licensing or user fees.

 

Health Hero Network, Inc., 2570 West El Camino Real, Suite 111, Mountain View, CA 94040, (650) 559-1000, http://www.healthhero.com

 

This company's system consists of Web-based software used by the care provider and a home messaging appliance, called the "Health Buddy," used by the patient. The patient supplies the blood pressure monitor. Providers can use the desktop software to develop queries, reminders, and tips tailored for various groups of patients, including patients with hypertension. Patients enrolled in the company's network service receive a messaging appliance, which plugs into an existing telephone line and, if the patient's monitor has digital output, into the monitor. The appliance prompts the patient to take a blood pressure reading and then transmits the data to the provider's computer terminal. Patients can view information and respond to questions from their providers on the appliance screen using four buttons. Blood pressure data can be analyzed and reported to providers in various forms, including bar graphs and tables. Patients receive scripted messages, such as reminders about actions they can take to control blood pressure and instructions on what to do if it rises out of range.

 

Participating institutions and provider practices pay a one-time licensing fee. The patient pays an undisclosed monthly fee for use of the messaging appliance and network service.