Monitoring Older Adult Blood Pressure Trends at Home as a Proxy for Brain Health.

Abstract

Even when older adults monitor hypertension at home, it is difficult to understand trends and share them with their providers. MyHealthNetwork is a dashboard designed for patients and providers to monitor blood pressure readings to detect hypertension and ultimately warning signs of changes in brain health. A multidisciplinary group in a Digital Health course at Tufts University School of Medicine used Design Thinking to formulate a digital solution to promote brain health among older adults in the United States (US). Older adults (aged 65 and over) are a growing population in the US, with many having one or more chronic health conditions including hypertension. Nearly half of all American adults ages 50-64 worry about memory loss as they age and almost all (90%) wish to maintain independence and age in their homes. Given the well-studied association between hypertension and dementia, we designed a solution that would ultimately promote brain health among older adults by allowing them to measure and record their blood pressure readings at home on a regular basis. Going through each step in the Design Thinking process, we devised MyHealthNetwork, an application which connects to a smart blood pressure cuff and stores users' blood pressure readings in a digital dashboard which will alert users if readings are outside of the normal range. The dashboard also has a physician view where users' data can be reviewed by the physician and allow for shared treatment decisions. The authors developed a novel algorithm to visually display the blood pressure categories in the dashboard in a way straightforward enough that users with low health literacy could track and understand their blood pressure over time. Additional features of the dashboard include educational content about brain health and hypertension, a digital navigator to support users with application use and technical questions. Phase 1 in the development of our application includes a pilot study involving recruitment of Primary Care Providers with patients who are at risk of dementia to collect and monitor BP data with our prototype. Subsequent phases of development involve partnerships to provide primary users with a rewards program to promote continued use, additional connections to secondary users such as family members and expansion to capture other health metrics.