Five steps to set up ambulatory blood pressure monitoring in your practice

With ambulatory blood pressure monitoring (ABPM), practices can send patients home with a portable monitor connected to a blood pressure (BP) cuff that automatically inflates at regular intervals and records many BP reading over a 24-hour period. This provides a wealth of data on what happens to patients’ BP when they’re asleep, eating, or just going about their daily activities. It’s also valuable for ruling out white coat hypertension.

Here are steps for establishing an ABPM program:

1. Determine the practice goals. Adding ABPM is a financial investment (about $2,000 to $2,500 per device), so practices need to be clear about why they’re adding the service, whether they have enough patient demand to support it, how many clinicians will be using it, and how much equipment will need to be purchased.

2. Determine eligibility criteria and cost for ABPM. Different payers cover ABPM for different indications. Some practices may choose to deploy it only for limited conditions that are widely covered such as resistant, masked, or white coat hypertension. Practices often charge $200 to $250 for ABPM, but reimbursements vary by payer.  

3. Create an APBM team. An effective ABPM team includes staff members who schedule patients, place and retrieve devices, prepare ABPM reports for clinician interpretation, and can support ABPM within the practice. No special certification is needed, but some training in placing ABPM devices and educating patients is advisable.

4. Select an ABPM device and software. Different devices have different costs, aesthetics, and software compatibility — some are more easily incorporated into existing electronic health record systems than others. Comparative information is available online, and device manufacturers can often arrange demonstrations.

5. Create an ABPM protocol. It should include information about preparing patients for the ABPM session. For example, practices could provide an information sheet that answers patients’ frequently asked questions, such as “Do I need special attire?” The protocol should also include steps for measuring arm circumference so the patient gets a cuff with the right fit, taking a test measurement before the patient leaves the office, collecting the device upon completion of monitoring, and analyzing the data.

Read the full FPM article: “Implementing Ambulatory Blood Pressure Monitoring in Primary Care Practice.”