Assessment Part 1 –NURS FPX 4900 assessment 3 Assessing the Problem: Technology Care Coordination and Community Resources Considerations CG

Hypertension is a common condition with severe health complications. According to Sawase et al. (2019), the prevalence hypertension is predicted to increase to 1.56 billion adults in 2025. On the other hand, the Centers for Disease Control and Prevention (CDC) reports that nearly half of adults in the United States (47%, 116 million) have hypertension.

Among the adults, 1 out of 4 adults (24%) with hypertension have their condition under control, and 45% with uncontrolled hypertension (CDC, 2020). For this assessment, the essay will inform how healthcare technology, coordination of care, and community resources can be applied to address hypertension to realize the quality of care, patient safety, and cost-effectiveness of patients.  

Impact of healthcare technology

Electronic health (E-health) can be defined as a collection of digital technologies used as a medium in delivering health services, more particularly through communication and information provision to patients, to help them manage their health more efficiently and ensure overall improvement of quality care. Healthcare technology plays a critical role among patients with hypertension.

According to Omboni et al. (2020), the most commonly used healthcare technology is m-health and telemedicine. Telemedicine allows the transmission of clinical information between patients and health professionals across the world through electronic communications as a way of diagnosing and caring for hypertensive patients (name). The most popular application for hypertension patients is Blood Pressure Tele-monitoring (BPT), which facilitates the exchange of medical data between patients and healthcare professionals, whereby services are offered remotely without necessary contact.

According to Timpel et al. (2020), BPT contains medical trackers and reminders that favor high-risk patients in self-management that adjunct the doctor’s intervention in medication. Based on this consideration, BPT can is deemed to foster patient medication adherence and increase participation in medication decision-making hence potentially improving care and successfully increasing the chances of controlling blood pressure. 

M-health refers to a health technology where healthcare services are facilitated through mobile devices of communication where data and information are exchanged between the patient and the healthcare professional (Zhang et al., 2021). Hypertensive patients use applications for m-health to provide educational information and measuring procedures for hypertensive patients. M-health technology is appropriate for patients with hypertension since it improves their medication adherence and allows remote monitoring, and is relatively cheap and convenient, considering that the technology relies on accessible devices and existing networks. 

Overall, healthcare technology allows for establishing long-term relationships with patients and healthcare professionals. Also, the utilization of the technology potentially empowers the patients’ positive behaviors and attitudes towards adherence to medication regimens, leading to an improved medical condition. Due to such factors, the accessibility of healthcare services is improved, and more patients are likely to receive medical care at their convenience.

For instance, considering an investigation conducted by Omboni et al. (2020) on hypertension management, research findings reported the importance of utilization of technology in improving self-monitoring, blood pressure control, and a decrease in risks associated with hypertension among patients. However, the major barrier associated with healthcare technology for hypertensive patients is the affordability of the internet.

Costs incurred in purchasing and maintaining internet-enabled networks can be overwhelming for some patients. On the other hand, a considerable proportion of people across the world are not connected due to a lack of skills to handle the devices, while others are due to language barriers. In addition, healthcare technology devices are prone to privacy and security issues considering that sensitive information is shared through the devices and that not all devices are regulated for privacy. 

Care Coordination to Address Hypertension  

Care coordination involves patient care activities that involve two or more healthcare providers participating in the provision of healthcare services to ensure the facilitation of service delivery. Care coordination is an essential component in ensuring patient satisfaction, quality care and safety, reduced medical errors, and cost-friendly services. In other words, a coordinated care plan for patients enhances patient outcomes and ensures their well-being.

According to Hanlin et al. (2018), uncoordinated or fragmented care can be overwhelming to the patients due to uncertainty of the care services, and the experience of communication gap could lead to reduced adherence to medication regimen, lack of satisfaction and loss of trust to healthcare professionals. With fragmented care, patients are likely to experience hospital readmissions, increased healthcare costs, and risk of increased emergence room visits. According to Omboni et al. (2019), in a hypertensive context, care coordination involves a multidisciplinary collaboration between healthcare providers who facilitate patient education, identify potential risk factors for hypertension, and ensure appropriate treatments are prescribed and modified during the dialog is maintained concerning the health care phase.

Multidisciplinary collaboration ensures that healthcare professionals such as pharmacists, nurses, and social workers share responsibilities in providing care to the patient, hence encouraging their engagement, and influencing their attitudes and behavior towards disease self-management. In this case, the prioritization of patient needs is an imperative method for coordinating care under multidisciplinary collaboration for hypertensive patients. 

Utilizing community resources to address hypertension 

Community resources can be defined as agencies (organizations, institutions, businesses, people, and activities) that facilitate health care support and services such as patient education, preventive and primary care services, and disease prevention programs within a community setting (Doyle et al., 2019).

The resources are critical in aiding ease of access to medical services since patients are allowed to connect with them based on their specific needs. For hypertension patients, community resources are considered basic needs since they are linked to key health determinants that are essential for disease management, including food, medication, healthcare affordability, housing, and other social services. 

NURS FPX 4900 assessment 3 Assessing the Problem: Technology Care Coordination and Community Resources Considerations CG

Utilization of community resources to address hypertension can be associated with appropriate referrals to community-based agencies by social workers and other healthcare professionals to ensure non-clinical needs are addressed. In this case, care coordination will be facilitated to ensure the patient receives relevant services based on hypertensive needs through multidisciplinary collaboration between social workers and healthcare professionals. For instance, a referral to community health education programs can be beneficial to patients with hypertension since they will gain a wider perspective on self-management, lifestyle modifications, and improved adherence to medications for appropriate control of blood pressure (Doyle et al., 2019).

The major community resources known to offer patient education for people experiencing hypertension are Health Safety Net and The American Heart Association. The agencies ensure that hypertensive patients are updated with crucial information and knowledge to promote wellness and health outcomes. However, lack of information concerning economic resources, inconsistent medical follow-ups, and inaccessibility to community resources can be potential barriers to patient hypertension management (Schwalm et al., 2019).

Also, health education programs can be a limitation to patients since most healthy terms are difficult to understand and comprehend for lay readers. Therefore, care coordination and community resources need to be utilized to ensure quality care is improved. 

Analysis of policies associated with hypertension

Healthcare policies associated with care coordination, community resources, and healthcare technology potentially influences hypertension, impacting the quality of care, patient safety, and costs incurred during medication. Policies such as the Affordable Care Act (ACA) potentially impact healthcare management for patients with hypertension. In particular, the enactment of ACA facilitates growth in healthcare technology since it provides incentives that allow the development and implementation of new systems aimed at increasing healthcare efficiency hence increasing quality care for hypertension patients.

With an increased focus on value-based care (accessibility of health insurance covers with medication payments based off), ACA facilitates the growth of telemedicine, which is linked further to cutting medication costs, enhancing patient satisfaction, and generate additional revenue. The enactment of ACA allowed the creation of opportunities for designation and facilitation of care delivery to promote care coordination leading to reduced costs and improved healthcare quality and quality (Mclntyre &Song, 2019).

Under the ACA, patient revenues are increased due to the expansion of health insurance and Medicaid, which facilitates the expansion of health centers and services within the community, making it affordable and effective in terms of costs, quality, and patient safety.  

The Georgia Board of Nursing (BON) contains developed nursing guidelines that inform on the procedures to facilitate care and services to patients. The board acknowledges the importance of the nursing code of ethics that directs on moral considerations for healthcare demands. The code of ethics informs on the appropriate measures to take that may require changes in healthcare systems, technology, and collaborations to ensure quality care and patient safety.

On the other hand, Cleverland et al. (2019) describe the effects of ACA legislation on the nursing scope of practice by contextualizing its effects on quality care, patient safety, and medication costs. According to him, ACA provides an initial legislative framework that links the concepts of quality care, value in health spending, and patient safety to payment initiatives.

Cleveland et al. provide that ACA established Hospitals readmission reduction program (HRRP) to track the practice of nurses on the medication costs, including readmissions. Through this idea, the nurses are likely to adhere to medication treatment plans that facilitate the reduction of medication costs and ensure quality care and patient safety. 

NURS FPX 4900 assessment 3 Assessing the Problem: Technology Care Coordination and Community Resources Considerations CG

Assessing the problem part 2

The assessment case for this practicum concerns Mr. Doe a 63-year-old Caucasian male who was diagnosed with hypertension two years ago. During a discussion with him on the phone, I assessed the impact of the disease based on quality care, safety, and cons considerations. While holding a discussion on quality care, Mr. Doe raised concerns about barriers he experienced while self-managing himself. Some of the barriers were limited knowledge, which influenced him to not adhere to the medication regimen.

Based on the knowledge I acquired from peer-reviewed articles and evidence-based documents such as Jaarsma et al. (2021), I learned that lack of adequate knowledge and skills is a significant barrier among hypertensive patients to comply with medication schedules. Mr. Doe confirmed that in his process of lifestyle modification, especially in the nutrition sector, it was uneasy for him to identify foods with high sodium content due to his limited knowledge.

While exploring Mr. Does’ experience on the effects of quality of care, safety, and costs, he acknowledged that his physician conducted minimal follow-ups in the previous medication course and did not provide adequate education and guidance on the medication conditions. Following that, he had limited knowledge and skills; he noticed no changes since his lifestyle was not modified. Consequently, he lost motivation to adhere to the medication regimen, and he admitted that due to his age, exercising was not appropriate. However, Mr. Doe admitted that he did not experience headaches, palpitations, or other comorbidities associated with hypertension.

From this perspective, Mr. Does’ quality of care can be termed low. Concerning patient safety issues, Mr. Doe admitted that his previous physician did not inform him of safety measures, self-management, or detection of changes in case blood pressure changed. I related the case with the knowledge I obtained from Hallberg et al. (2018) that self-management is central for hypertension patients. Further, following that, Mr. Doe experienced no changes; he opted to change his medication regimen, which he further incurred costs.

The several appointments he held with different physicians and healthcare professionals to inform him of the management measure cost him a lot of money, considering that his condition does not allow him to work and earn. Overall, the major concern for Mr. Doe that I noted is limited knowledge and skills to allow him to facilitate self-management for effective control of blood pressure. 

Conclusion

In summary, the assessment of hypertension under the impact of healthcare technology, coordination of care, and community resources requires overall consideration of patient quality care, safety, and cost considerations. Health care professionals play a role in facilitating and coordinating care provisions for hypertensive patients.

From the assessment, lack of knowledge, skills, and adequate education are the major barriers to hypertension management. Therefore, by addressing the issues through healthcare technology, utilization of community resources, and care coordination, patient outcomes will be improved. 

References

CDC (2020). Facts About Hypertension in the United States https://www.cdc.gov/bloodpressure/facts.htm  

Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable care: harnessing the power of nurses. Online Journal of Issues in Nursing, 24(2).

Doyle, S. K., Chang, A. M., Levy, P., & Rising, K. L. (2019). Achieving health equity in hypertension management through addressing the social determinants of health. Current hypertension reports, 21(8), 1-6.

Hanlin, R. B., Asif, I. M., Wozniak, G., Sutherland, S. E., Shah, B., Yang, J., … & Egan, B. M. (2018). Measure accurately, act rapidly, and partner with patients (MAP) improves hypertension control in medically underserved patients: Care Coordination Institute and American Medical Association Hypertension Control Project Pilot Study results. The Journal of Clinical Hypertension, 20(1), 79-87.

McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a decade. PLoS medicine, 16(2), e1002752.

NURS FPX 4900 assessment 3 Assessing the Problem: Technology Care Coordination and Community Resources Considerations CG

Omboni, S., McManus, R. J., Bosworth, H. B., Chappell, L. C., Green, B. B., Kario, K., … & Wakefield, B. J. (2020). Evidence and recommendations on the use of telemedicine for the management of arterial hypertension: an international expert position paper. Hypertension, 76(5), 1368-1383.

Omboni, S., Tenti, M., & Coronetti, C. (2019). Physician–pharmacist collaborative practice and telehealth may transform hypertension management. Journal of human hypertension, 33(3), 177-187.

Sawase, G. B., Kumthekar, S. G., Salphale, S. N., & Doibale, M. K. (2019). A study of the prevalence of hypertension and socio-demographic factors in urban slum, Maharashtra.

Schwalm, J. D., McCready, T., Lopez-Jaramillo, P., Yusoff, K., Attaran, A., Lamelas, P., … & Yusuf, S. (2019). A community-based comprehensive intervention to reduce cardiovascular risk in hypertension (HOPE 4): a cluster-randomised controlled trial. The Lancet, 394(10205), 1231-1242.

Timpel, P., Oswald, S., Schwarz, P. E., & Harst, L. (2020). Mapping the evidence on the effectiveness of telemedicine interventions in diabetes, dyslipidemia, and hypertension: an umbrella review of systematic reviews and meta-analyses. Journal of medical Internet research, 22(3), e16791.Zhang, W., Cheng, B., Zhu, W., Huang, X., & Shen, C. (2021). Effect of telemedicine on quality of care in patients with coexisting hypertension and diabetes: a systematic review and meta-analysis. Telemedicine and e-Health, 27(6), 603-614.

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