Implementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection

Abstract

Remote monitoring of women experiencing hypertensive disorders of pregnancy (HDP) can provide timely life-saving data, particularly if these data are integrated into existing patient and clinical workflows. This pilot intervention of a smartphone application (app) for postpartum monitoring of hypertensive disorders integrates patient-contributed data into electronic health records (EHRs) to support monitoring and clinical decision-making. Results from the evaluation of the pilot highlight the resources needed when implementing the app, challenges for integrating an app into the EHR, and the usability and utility of the HDP monitoring app for patient and clinician users. The implementation team's key observations included the importance of a local clinical champion, more robust patient involvement and support for the remote patient monitoring program, an impetus for EHR developers to adopt data integration standards, and a need to expand the capabilities of the standards to support interventions using patient-contributed data.

Keywords: clinical decision support systems; patient centered care; patient-generated health data; women’s health.

Figure 1.

HDPM workflow (steps 1-13).

Figure 2.

Sample patient symptom questionnaire.

Figure 3.

Example flowsheet with alert value. Alert icon highlighted with arrow.