Abstract
Although many aspects of our lives have been transformed by digital innovation, widespread
adoption of digital health advancements within the health care sector in general,
and for hypertension care specifically, has been limited. However, it is likely that,
over the next decade, material increases in the uptake of digital health innovations
for hypertension care delivery will be seen. In this narrative review, we summarise
those innovations thought to have the greatest chance for impact in the next decade.
These include provision of virtual care combined with home blood pressure (BP) telemonitoring,
use of digital registries and protocolised care, leveraging continuous BP measurement
to collect vast amounts of individual and population-based BP data, and adoption of
digital therapeutics to provide low-cost scalable interventions for patients with
or at risk for hypertension. Of these, home BP telemonitoring is likely the most ready
for implementation, but it needs to be done in a way that enables efficient guideline-concordant
care in a cost-effective manner. In addition, efforts must be focused on implementing
digital health solutions in a manner that addresses the major challenges to digital
adoption. This entails ensuring that innovations are accessible, usable, secure, validated,
evidence based, cost-effective, and integrated into the electronic systems that are
already used by patients or providers. Increasing the use of broader digital innovations
such as artificial/augmented intelligence, data analytics, and interactive voice response
is also critically important. The digital revolution holds substantial promise, but
success will depend on the ability of collaborative stakeholders to adopt and implement
innovative, usable solutions.
Résumé
Bien que l’innovation numérique ait déjà transformé de nombreux aspects de notre vie,
force est de constater que l’adoption à grande échelle des découvertes dans le domaine
de l’information numérique sur la santé n’a pas, dans le secteur des soins de santé
en général et plus particulièrement de l’hypertension, demeure limitée. Cependant,
il est probable qu’au cours de la prochaine décennie le déploiement du matériel pour
l’adoption des innovations en information numérique sur la santé connaîtra un essor
dans la prise en charge thérapeutique de l’hypertension. Dans cet article de synthèse,
nous dresserons un résumé des innovations susceptibles d’avoir la plus grande incidence
au cours de la prochaine décennie. Ces innovations comprennent la prestation de soins
virtuels de pair avec la télésurveillance de la pression artérielle (PA) à domicile,
l’utilisation de registres numériques et de protocoles thérapeutiques, le recours
à la mesure continue de la PA pour la collecte de grandes quantités de données auprès
des individus et des populations, et l’adoption de la thérapeutique numérique pour
offrir des interventions évolutives à faible coût aux patients atteints d’hypertension
ou prédisposés à celle-ci. Parmi toutes ces innovations, la télésurveillance de la
PA à domicile est sans doute celle dont la mise en œuvre est la plus probable, mais
cela doit se faire de manière à favoriser des soins efficaces et économiques dans
le respect des lignes directrices. De plus, il faut veiller à instaurer des solutions
d’information numérique sur la santé qui visent à résoudre les difficultés que pose
l’adoption du numérique. Ainsi, ces innovations doivent être accessibles, utilisables,
sécuritaires, validées, économiques et fondées sur des données probantes, et s’intégrer
aux systèmes électroniques que les patients ou les soignants utilisent déjà. Il est
également très important d’accroître l’utilisation d’innovations numériques plus vastes
telles que l’intelligence artificielle ou amplifiée, l’analyse des données et la réponse
vocale interactive. La révolution numérique est prometteuse, mais sa réussite dépendra
de la capacité des divers intervenants à adopter et à mettre en œuvre des solutions
innovantes et utilisables.
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Article info
Publication history
Published online: December 16, 2020
Accepted:
December 10,
2020
Received:
October 14,
2020
Footnotes
See page 719 for disclosure information.
Identification
Copyright
Crown Copyright © 2020 Published by Elsevier Inc. on behalf of the Canadian Cardiovascular Society. All rights reserved.
