Integrating Scalability and Equity into Hypertension Remote Patient Monitoring Program Design

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. Summary: 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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UNC Libraries
Published
2026-10-30
DOI
https://doi.org/10.17615/84d3-fg63
Primary Topic
Telemedicine and Telehealth Implementation
Type
article
Field-Weighted Citation Impact
0.00

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article

Integrating Scalability and Equity into Hypertension Remote Patient Monitoring Program Design

Sharon Rikin, Jennifer Cluett, Kelsey B. Bryant, Jacqueline R. Halladay et al.
4 links
UNC Libraries
Telemedicine and Telehealth Implementation
article

Integrating Scalability and Equity into Hypertension Remote Patient Monitoring Program Design

Sharon Rikin, Jennifer Cluett, Kelsey B. Bryant, Jacqueline R. Halladay, Ian Matthew Kronish, Karen L. Margolis, Harry West, Yvonne Commodore-Mensah, Eun Ji Kim
article en

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. Summary: 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.

UNC Libraries
University of North Carolina at Chapel Hill (US)
Carnegie Corporation of New York, Prostate Cancer Foundation, Oak Foundation, Styrelsen för Internationellt Utvecklingssamarbete, Suomen Lääketieteen Säätiö, Pakistan Science Foundation, Wellcome Trust, National Research Foundation of Ukraine, University of Carthage, National Institute for Health and Care Research, British Heart Foundation, Leverhulme Trust, Academy of Medical Sciences, Deutsche Forschungsgemeinschaft, Ministry of Education, Culture, Sports, Science and Technology, Danida Fellowship Centre, National Natural Science Foundation of China, ZonMw, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Austrian Science Fund, Ministry of Higher Education, Malaysia, Natural Science Foundation of Guangdong Province, Department of Education of Hebei Province, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Iran National Science Foundation, Ligue Contre le Cancer, Narodowe Centrum Nauki, Signe ja Ane Gyllenbergin Säätiö, Javna Agencija za Raziskovalno Dejavnost RS, Ministarstvo Prosvete, Nauke i Tehnološkog Razvoja, Ministerstwo Edukacji i Nauki, Natural Science Foundation of Jiangsu Province, University of Science Ho Chi Minh City, Uniwersytet Medyczny w Bialymstoku, Norges Forskningsråd, Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina, Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco, Sigrid Juséliuksen Säätiö, Natural Science Foundation of Shandong Province, Universitas Airlangga, Innovatiefonds Zorgverzekeraars, Novo Nordisk Fonden, Taichung Veterans General Hospital, Department of Education of Guangdong Province, State Key Laboratory of Tribology, Diabetes Wellness Suomi Säätiö, Diabetestutkimussäätiö, Universitas Padjadjaran, Alzheimer’s Society, UK Dementia Research Institute, Centre Hospitalier Universitaire de Poitiers, National Institute for Health Research Southampton Biomedical Research Centre, Direktoratet for Utviklingssamarbeid, Key Research and Development Program of Ningxia, Canadian Institutes of Health Research, University of South Florida Research and Innovation, Natural Sciences and Engineering Research Council of Canada, Fundação para a Ciência e a Tecnologia, Programme Grants for Applied Research, Marsden Fund, National Key Research and Development Program of China, Chiayi Chang Gung Memorial Hospital, NIHR School for Primary Care Research, Fogarty International Center, National Institute of Neurological Disorders and Stroke, Eunice Kennedy Shriver National Institute of Child Health and Human Development, EIT Health
Reduced inequalities, Good health and well-being
Openalex Percentile: Top 10%
Telemedicine and Telehealth Implementation
DOIOpen Access PDFOpenAlex
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