Subscribe to RSS
Workflow Automation for a Virtual Hypertension Management Program
Objectives Hypertension is a modifiable risk factor for numerous comorbidities and treating hypertension can greatly improve health outcomes. We sought to increase the efficiency of a virtual hypertension management program through workflow automation processes.
Methods We developed a customer relationship management (CRM) solution at our institution for the purpose of improving processes and workflow for a virtual hypertension management program and describe here the development, implementation, and initial experience of this CRM system.
Results Notable system features include task automation, patient data capture, multi-channel communication, integration with our electronic health record (EHR), and device integration (for blood pressure cuffs). In the five stages of our program (intake and eligibility screening, enrollment, device configuration/setup, medication titration, and maintenance), we describe some of the key process improvements and workflow automations that are enabled using our CRM platform, like automatic reminders to capture blood pressure data and present these data to our clinical team when ready for clinical decision making. We also describe key limitations of CRM, like balancing out-of-the-box functionality with development flexibility. Among our first group of referred patients, 76% (39/51) preferred email as their communication method, 26/51 (51%) were able to enroll electronically, and 63% of those enrolled (32/51) were able to transmit blood pressure data without phone support.
Conclusion A CRM platform could improve clinical processes through multiple pathways, including workflow automation, multi-channel communication, and device integration. Future work will examine the operational improvements of this health information technology solution as well as assess clinical outcomes.
Keywordsworkflow automation - clinical innovation - blood pressure monitoring - customer relationship management
Protection of Human and Animal Subjects
This work is a quality improvement project at Mass General Brigham whose sole purpose is quality measurement and thus under institution guidelines the work was not reviewed by the Mass General Brigham Human Research Committee.
* These authors contributed equally to this manuscript.
Received: 03 June 2021
Accepted: 23 September 2021
10 November 2021 (online)
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 Yoon SS, Gu Q, Nwankwo T, Wright JD, Hong Y, Burt V. Trends in blood pressure among adults with hypertension: United States, 2003 to 2012. Hypertension 2015; 65 (01) 54-61
- 2 Blood Pressure Lowering Treatment Trialists' Collaboration. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet 2021; 397 (10285): 1625-1636
- 3 Jones DW, Whelton PK, Allen N. et al. Management of stage 1 hypertension in adults with a low 10-year risk for cardiovascular disease: filling a guidance gap: a scientific statement from the American Heart Association. Hypertension 2021; 77: e58-e67
- 4 Muntner P, Hardy ST, Fine LJ. et al. Trends in blood pressure control among US adults with hypertension, 1999-2000 to 2017-2018. JAMA 2020; 324 (12) 1190-1200
- 5 Rethy L, Shah NS, Paparello JJ, Lloyd-Jones DM, Khan SS. Trends in hypertension-related cardiovascular mortality in the United States, 2000 to 2018. Hypertension 2020; 76 (03) e23-e25
- 6 World Health Organization. Hypertension. Accessed April 16, 2021 at: https://www.who.int/westernpacific/health-topics/hypertension
- 7 Scirica BM, Cannon CP, Fisher NDL. et al. Digital care transformation: interim report from the first 5000 patients enrolled in a remote algorithm-based cardiovascular risk management program to improve lipid and hypertension control. Circulation 2021; 143 (05) 507-509
- 8 Weaver KK. Collaborative practice agreements: explaining the basics. Pharm Today 2018; 24 (03) 55
- 9 Wright A, Salazar A, Mirica M, Volk LA, Schiff GD. The invisible epidemic: neglected chronic disease management during COVID-19. J Gen Intern Med 2020; 35 (09) 2816-2817
- 10 Fisher NDL, Fera LE, Dunning JR. et al. Development of an entirely remote, non-physician led hypertension management program. Clin Cardiol 2019; 42 (02) 285-291
- 11 Blood AJ, Fischer CM, Fera LE. et al. Rationale and design of a navigator-driven remote optimization of guideline-directed medical therapy in patients with heart failure with reduced ejection fraction. Clin Cardiol 2020; 43 (01) 4-13
- 12 Chen Injazz J. Popovich Karen. Understanding customer relationship management (CRM): People, process and technology. Bus Process Manag J 2003; 9 (05) 672-688
- 13 Gartner. Gartner Says Worldwide Customer Experience and Relationship Management Software Market Grew 15.6% in 2018. Published June 17, 2019. Accessed April 19, 2021 at: https://www.gartner.com/en/newsroom/press-releases/2019-06-17-gartner-says-worldwide-customer-experience-and-relati
- 14 HIMSS Interoperability & Health Information Exchange Community. HIE Case Study: CRM Solutions in Elder Care—The Maplewood.; 2019. Accessed July 12, 2021 at: https://www.himss.org/sites/hde/files/media/file/2020/07/21/himss_crm_casestudy_themaplewood.pdf
- 15 Baashar Y, Alhussian H, Patel A. et al. Customer relationship management systems (CRMS) in the healthcare environment: a systematic literature review. Comput Stand Interfaces 2020; 71: 103442-103442
- 16 Sanchis R, García-Perales O, Fraile F, Poler R. Low-code as enabler of digital transformation in manufacturing industry. Appl Sci (Basel) 2019; 10: 12
- 17 Jones SS, Heaton PS, Rudin RS, Schneider EC. Unraveling the IT productivity paradox—lessons for health care. N Engl J Med 2012; 366 (24) 2243-2245
- 18 Halamka JD, Tripathi M. The HITECH Era in retrospect. N Engl J Med 2017; 377 (10) 907-909
- 19 Unertl KM, Novak LL, Johnson KB, Lorenzi NM. Traversing the many paths of workflow research: developing a conceptual framework of workflow terminology through a systematic literature review. J Am Med Inform Assoc 2010; 17 (03) 265-273
- 20 Zheng K, Ratwani RM, Adler-Milstein J. Studying workflow and workarounds in electronic health record-supported work to improve health system performance. Ann Intern Med 2020; 172 (suppl 11): S116-S122
- 21 Carrera A, Pifarré M, Vilaplana J. et al. BPcontrol. A mobile app to monitor hypertensive patients. Appl Clin Inform 2016; 7 (04) 1120-1134
- 22 Poku MK, Behkami NA, Bates DW. Patient relationship management: what the U.S. healthcare system can learn from other industries. J Gen Intern Med 2017; 32 (01) 101-104
- 23 Yaghoubi M, Asgari H, Javadi M. The impact of the customer relationship management on organizational productivity, customer trust and satisfaction by using the structural equation model: a study in the Iranian hospitals. J Educ Health Promot 2017; 6: 6
- 24 PRNewswire. Global Healthcare CRM Market 2018–2023 Featuring Key Players. Published November 22, 2018. Accessed April 20, 2021 at: https://www.prnewswire.com/news-releases/global-healthcare-crm-market-2018-2023-featuring-key-players—salesforce-sap-oracle-microsoft-ibm-influence-health-sugarcrm-accenture-healthgrades-and-infor-300754682.html