Telehealth support tied to better blood pressure control in Black patients

A telehealth navigator program was associated with improved blood pressure control among Black adults with hypertension at federally qualified health centers, according to researchers from Harvard Pilgrim Health Care Institute, Boston University and Boston Medical Center. The finding points to a possible model for addressing racial gaps in cardiovascular care through primary care teams, remote monitoring and community health workers.

The study, published in the Journal of General Internal Medicine, examined a program designed to help patients use virtual care, keep up with appointments and monitor blood pressure at home. Researchers reported that participation was linked to a 31.4-percentage-point increase in the likelihood that a patient’s blood pressure was controlled.

How the program worked

The intervention placed telehealth navigators inside federally qualified health centers, known as FQHCs. The navigators were community health workers embedded in primary care practices, according to Harvard Pilgrim Health Care Institute.

Their work included helping patients schedule visits, use virtual care platforms and track blood pressure outside the clinic through remote patient monitoring tools. Megan Cole Brahim, a Harvard Medical School associate professor of population medicine at the Harvard Pilgrim Health Care Institute and the study’s senior author, said the role can support patients by building trust, coordinating care and helping them use digital health tools.

Brahim also said telehealth navigators can connect patients with social and behavioral services that may influence blood pressure. Hypertension is a major risk factor for heart disease, and Black patients face disproportionate burdens in prevalence and outcomes, the researchers said.

The program was created and carried out by Community Care Cooperative, or C3, in partnership with the research team. C3 is a nonprofit accountable care organization founded and governed by federally qualified health centers in Massachusetts.

Study compared similar patients

The researchers used a quasi-experimental design and electronic health record data to evaluate the program. They compared Black adults with hypertension who enrolled in the navigator intervention with similar patients at other federally qualified health centers that did not use the program.

Among participants, the likelihood of controlled blood pressure rose by more than 30 percentage points compared with similar patients who did not receive the intervention, according to the study. The researchers also found a short-term increase in primary care engagement, though that effect did not continue after the first few months.

The publication identifies the study as “Impact of a Telehealth Navigator Intervention on Hypertension Control Among Black Patients Served by Federally Qualified Health Centers.” Kenneth N. Lim and colleagues authored the paper, according to the journal listing.

Policy questions remain

The findings add to evidence that combining care coordination, community-based support and digital tools can improve outcomes for patients who face barriers to care, the researchers said. Brahim said expanding telehealth navigator programs in primary care, along with remote patient monitoring, may help improve hypertension outcomes in populations affected by health disparities.

The authors also pointed to practical limits on broader use. Brahim said programs like this will need stable support, including payment for community health worker roles and remote patient monitoring services.

The researchers said wider adoption would depend on health systems and policymakers backing care models that make telehealth navigators part of care teams. The study does not present the program as a stand-alone solution, but as a primary care-based approach that may help improve control of a common and preventable driver of cardiovascular disease.

This story draws on original reporting from Medical Xpress.