Remote monitoring catches a hidden heart problem just in time

For most of his adult life, Dennis Backer managed his high blood pressure with medication. Now 80, he had always been able to keep it under control until recently, when his numbers suddenly became unpredictable.

His primary care physician recommended that he join UC Davis Health's Remote Patient Monitoring (RPM) program for high blood pressure. This would allow the care team to track his readings more closely and guide him through any needed medication or lifestyle changes.

What the team found surprised everyone.

A program designed for safety and early intervention

Patients enrolled in the RPM program check their blood pressure from home using connected devices such as blood pressure cuffs and scales. These devices send readings to the UC Davis Population Health team, which includes a doctor, pharmacist, nurse and medical assistant. The team watches these readings daily to make sure they stay in a healthy range and catch problems early.

UC Davis Health enrolls about 40 new participants each month and has around 180 patients active in the program. The program also offers group classes, one-on-one coaching and help with medications. It lasts six months, but those who need more time to reach their goals can stay for up to a year.

"The program looks at all the factors that affect a person's ability to manage high blood pressure," said Katie McHenry, a supervisor for the RPM program. "With daily monitoring and quick follow-up, the team can spot problems early - before they become emergencies."

Cross-team collaboration to prevent emergencies

The population health care team uses a color-coded report to quickly flag patient blood pressure readings outside normal limits. When a patient's numbers look concerning, the population health team works with UC Davis Health's nurse triage team to check on the patient.

"When we see a reading that's outside a safe range, we reach out right away. Sometimes patients don't realize how quickly blood pressure can change, so a simple check-in can make a big difference," explained registered nurse Brianne Harms, who is serving as lead for the RPM program in nurse triage. "The RPM program helps us identify and reach patients quickly to adjust medications or address concerns before they become emergencies."

The nurse triage team provides comprehensive triage by phone and clinical advice for all of UC Davis Health's RPM? patients. On average, the department handles 400 to 500 patient calls per day. Using evidence-based protocols and expert nursing judgment, the nurse triage team evaluates each patient's needs and determines the most appropriate level of care.

"With over 700 years of combined RN experience, our nurse triage team knows how to get patients the right care at the right time," shared Rachel Teixeira, nurse manager of UC Davis Health nurse triage. "Collaborating with the RPM program is another example of how we're driving innovation to make health care more convenient, more accessible and more equitable for every patient."

A subtle warning that might have been missed

After several weeks in the RPM program, Becker's care team noticed something unusual in his daily readings: his heart rate was dropping even though his blood pressure looked normal. At one point, his pulse fell into the 50s, then later into the mid-40s.

Even with these low numbers, Becker felt fine. Each time the triage nurses called, he reported no dizziness, shortness of breath or chest pain - nothing out of the ordinary.

Still, the readings continued to raise concern. One afternoon, he received another call - his heart rate had fallen to 36 beats per minute. Even without symptoms, nurse triage recommended he go to the emergency department.

"A heart rate that low can be a sign that something serious is happening beneath the surface," said triage nurse Sumali Valentine, who had spoken with Becker. "Even if a patient feels fine, we don't want to take chances. Our job is to make sure they get evaluated quickly so we can rule out anything dangerous."

At the hospital, Becker's heart rate dropped as low as 29. Doctors admitted him and determined he needed a pacemaker to keep his heart beating safely. After six days in the hospital, he received the device, and his condition stabilized.

After the procedure, Becker's blood pressure improved. He now feels safer knowing the UC Davis Health team is watching out for him.

"I never had a single warning sign and had no idea I was at high risk," Becker shared. "If it weren't for that remote monitoring program, who knows what would have happened?"

Related stories:

• New at-home monitoring program for patients with high blood pressure
• Remote monitoring shows real results: UC Davis Health helps patients lower blood pressure at home