Hypertension (high blood pressure) is the greatest risk factor for developing cardiovascular disease. In the Netherlands, almost a third of people between 30 and 70 years old have high blood pressure. The early detection, management and treatment of hypertension (Cardiovascular Risk Management) is therefore crucial in improving public health, reducing the number of deaths and decreasing healthcare costs. Ahti is currently developing two projects for Cardiovascular Risk Management (CVRM): DHoTS and Athena. Digitisation (e-health) plays an important role in these projects, because of the potential for saving time and money and supporting the care process involving the patient, the care provider and the payer. We are currently working on both projects in the City of Amsterdam. We are working with Amsterdam UMC – AMC site, the Amsterdam Regional General Practice Forum (ROHA) and Heart for Health ICT.

Cardiovascular disease is the leading cause of death worldwide

Globally, more people die from cardiovascular disease than any other cause. On an annual basis, almost a third of deaths are caused by cardiovascular disease (source: World Health Organization). In the Netherlands, too, cardiovascular disease is a major cause of (premature) death and disability. The annual cost of healthcare associated with cardiovascular disease is €8.3 billion.

Hypertension (high blood pressure) is the greatest risk factor for developing cardiovascular disease. In the Netherlands, almost a third of people between 30 and 70 years old have high blood pressure (source: RIVM). The early detection, management and treatment of hypertension (Cardiovascular Risk Management) is therefore crucial in improving public health, reducing the number of deaths and decreasing healthcare costs. Furthermore, if the patient is involved in this process, they are able to manage their own care and control the quality of their care. The net result is a healthier population, who are more satisfied with the care they receive, which is delivered at a lower cost (triple aim).

Two CVRM projects

To address this challenge, ahti is developing two related projects for Cardiovascular Risk Management (CVRM), which incorporate the three pillars of the triple aim. Digitisation (e-health) plays an important role in these projects, because of the potential for saving time and money and supporting the care process involving the patient, the care provider and the payer. Another important role is that of the GP. In the Netherlands, the GP is the first person in the CVRM care chain you come into contact with if you have high blood pressure.

1. Amsterdam Telemonitoring and Hypertension Initiative (ATHENA)
   In collaboration with Amsterdam UMC – AMC site and Heart for Health ICT, partially funded by Health~Holland (Life Sciences & Health Top Sector), ahti is developing and testing a self-monitoring tool for patients with hypertension. This tool allows patients to take their own blood pressure regularly from the comfort of their home. The results are then integrated into an automated triage and treatment system, powered by smart algorithms. In this way, the patient receives bespoke medication and treatment advice for regulating their blood pressure. The advice is aligned with the patient’s personal situation.
2. Connecting the DHoTS: Digital Health from Technology to Services
   We are also integrating the aforementioned self-management tool for patients with hypertension into GPs’ practices and digital environments. The patient takes their blood pressure at home. The self-management tool automatically sends the results to the patient’s GP, who offers personalised advice, providing the patient has consented, of course. This process allows the GP to keep a closer eye on things and maintain a more continuous watch. The patient remains in charge of their own health situation. In an emergency, the professional can adjust the treatment plan.

We are developing a Digital Health Platform to ensure the sustainable, efficient and effective integration of this service into the wider care process involving the patient, the professional and the payer. The platform supports the operational, financial and technical aspects of the digital CVRM care services. The platform is also suitable for future extension to cover other areas of healthcare, such as diabetes, asthma and COPD care.

Status of ATHENA and DHoTS

ATHENA: Since the DHoTS started, the focus of the ATHENA project has shifted to providing a scientific basis for the algorithm we will be using in the DHoTS GP portal. The data for the portal must be collected carefully and in accordance with GDPR requirements. The project will therefore run until the end of 2020.

DHoTS: There is a functioning GP portal where we can display treatment advice and risk assessment generated using an algorithm (in accordance with the Dutch College of General Practitioners’ guidelines). There is also a mobile app that patients can use to record their own blood pressure. Pharos (the institute that supports people with poor literacy skills) is one of the bodies involved in development of the application. So far eight GPs and more than 130 patients are participating and able to take their blood pressure at home, and the numbers are rising. We are currently developing a website with more information for GPs and patients.

Partners

• Amsterdam UMC – AMC site
• Amsterdam Regional General Practice Forum (ROHA)
• Heart for Health

This project is supported financially by the European Regional Development Fund (EFRO).

Contact

Want more information or do you have a question? Please contact Barbara Wendrich (DHoTS Project Leader)