Integrating Scalability and Equity into Hypertension Remote Patient Monitoring Program Design.
9 affiliations
- 1Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, USA.
- 2Division of General Internal Medicine, Mount Sinai, New York, NY, USA.
- 3Johns Hopkins School of Nursing, Baltimore, MD, USA.
- 4Department of Family Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
- 5Northwell Health, Hyde Park, NY, USA.
- 6HealthPartners Institute, Bloomington, MN, USA.
- 7Department of Medicine, Montefiore Einstein and Albert Einstein College of Medicine, Bronx, NY, USA.
- 8Department of Industrial Engineering and Operations Research, Columbia Engineering, Columbia University, New York, NY, USA.
- 9Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. [email protected].
Abstract
Purpose of review
Remote patient monitoring (RPM) for hypertension combines home blood pressure (BP) monitoring with electronic transmission of BP readings and clinical support. RPM has the potential to improve BP control and reduce hypertension disparities, but because it depends on devices, connectivity, digital literacy, and sustained engagement, it may also worsen inequities if not intentionally designed. This review examines barriers to equitable RPM implementation and strategies to address them.Recent findings
RPM can improve hypertension control and extend care beyond traditional clinical settings, but its effect on health equity depends on program design. Equity should be treated as a core design principle. Future research should evaluate differential reach, engagement, effectiveness, and sustainability across populations and identify payment models that support equitable implementation at scale. Barriers to equitable RPM implementation occur at patient, clinician, health system, and policy levels. Key challenges include limited access to technology, language barriers, out-of-pocket costs, inadequate cuff sizing, unmet social needs, clinician workload, referral bias, infrastructure limitations, reimbursement variability, and the digital divide. Emerging evidence suggests that equity-focused strategies can improve reach and engagement, including provision of cellular-enabled devices, reduced patient costs, culturally and linguistically tailored support, team-based care, registry-based outreach, and routine monitoring of enrollment and outcomes across demographic groups. High-resource, low-resource, and hybrid RPM models each offer distinct advantages and tradeoffs in balancing scalability, sustainability, and equity.
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BibTeX
@article{kronish2026integrating,
title = {{Integrating Scalability and Equity into Hypertension Remote Patient Monitoring Program Design.}},
author = {Ian M Kronish and Kelsey B Bryant and Yvonne Commodore-Mensah and Jacqueline R Halladay and Eun Ji Kim and Karen L Margolis and Sharon Rikin and Harry West and Jennifer L Cluett},
journal = {Current hypertension reports},
year = {2026},
month = oct,
doi = {10.1007/s11906-026-01393-4},
url = {https://europepmc.org/article/MED/42911359},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Integrating Scalability and Equity into Hypertension Remote Patient Monitoring Program Design.
AU - Ian M Kronish
AU - Kelsey B Bryant
AU - Yvonne Commodore-Mensah
AU - Jacqueline R Halladay
AU - Eun Ji Kim
AU - Karen L Margolis
AU - Sharon Rikin
AU - Harry West
AU - Jennifer L Cluett
PY - 2026
DA - 2026/10/22
JO - Current hypertension reports
DO - 10.1007/s11906-026-01393-4
UR - https://europepmc.org/article/MED/42911359
AB - Purpose of review Remote patient monitoring (RPM) for hypertension combines home blood pressure (BP) monitoring with electronic transmission of BP readings and clinical support. RPM has the potential to improve BP control and reduce hypertension disparities, but because it depends on devices, connectivity, digital literacy, and sustained engagement, it may also worsen inequities if not intentionally designed. This review examines barriers to equitable RPM implementation and strategies to address them.Recent findings RPM can improve hypertension control and extend care beyond traditional clinical settings, but its effect on health equity depends on program design. Equity should be treated as a core design principle. Future research should evaluate differential reach, engagement, effectiveness, and sustainability across populations and identify payment models that support equitable implementation at scale. Barriers to equitable RPM implementation occur at patient, clinician, health system, and policy levels. Key challenges include limited access to technology, language barriers, out-of-pocket costs, inadequate cuff sizing, unmet social needs, clinician workload, referral bias, infrastructure limitations, reimbursement variability, and the digital divide. Emerging evidence suggests that equity-focused strategies can improve reach and engagement, including provision of cellular-enabled devices, reduced patient costs, culturally and linguistically tailored support, team-based care, registry-based outreach, and routine monitoring of enrollment and outcomes across demographic groups. High-resource, low-resource, and hybrid RPM models each offer distinct advantages and tradeoffs in balancing scalability, sustainability, and equity.
SN - 1522-6417
SN - 1534-3111
ER -