The U.S. Department of Health and Human Services (HHS) Office on Women’s Health (OWH) is excited to announce the 15 Phase 2 awardees of the HHS Hypertension Innovator Award Competition. The national competition was developed by OWH to identify programs that use innovative methods of blood pressure monitoring and follow-up to care during pregnancy and postpartum.  Data from the Centers for Disease Control and Prevention show that 56% of non-Hispanic black adults have high blood pressure, which is a significantly higher rate than other populations.  This competition, along with the OWH Self-Measured Blood Pressure Program, is part of a concerted effort to address disparities in populations with a higher risk of having high blood pressure and the negative outcomes related to cardiovascular disease. 

OWH hosted National Women’s Blood Pressure Awareness Week Summit where awardees from Phase 1 presented innovative methods used to improve health within their communities.  Phase 2 of the competition is rewarding programs from Phase 1 that demonstrated sustainability and the ability to replicate and/or expand effective monitoring and follow-up of hypertension.  Our focus on expansion is a vital part of our commitment to reduce the rates of maternal morbidity and mortality and improve maternal health outcomes during pregnancy and postpartum.  This initiative supports the White House Blueprint for Addressing the Maternal Health Crisis.

The 15 awardees of Phase 2 of the HHS Hypertension Innovator Award Competition are listed below:

1.    Boston Medical Center – Boston, MA

Program/Focus: Remote Cloud Connected Postpartum Blood Pressure Monitoring Program

Remote Cloud Connected Postpartum Blood Pressure Monitoring Program uses a cloud-based software platform to identify high-risk women at Boston Medical Center and provide them with a cloud-connected blood pressure cuff for six weeks following their discharge from delivery hospitalization.  Their approach led to the risk of readmission among patients with severe hypertension at discharge to decrease from 18.4% to 5.7%.  They have expanded monitoring of their high-risk population through the addition of a high-risk obstetric nurse, improved their platform to optimize population management, and incorporated their pharmacy team under a collaborative care agreement to provide prescriptions according to an algorithm written by their maternal-fetal medicine lead.   

2.    Brigham and Women’s Hospital – Boston, MA

Program/Focus: Improving Outcomes by Empowering Women After Hypertensive Pregnancy

Improving Outcomes by Empowering Women After Hypertensive Pregnancy focuses on the transition from obstetric to primary care in the postpartum period.  During the COVID-19 pandemic, this program pivoted to a virtual format with the engagement of a racially, culturally, and socioeconomically diverse patient population.  The program had 98% of their participants successfully control their blood pressure postpartum and increased rates of blood pressure monitoring from 56.8% to 93.8%.  

3.    CommonSpirit Health – Chicago, IL

Program/Focus: Maternal Hypertension Initiative (MHI)

The Maternal Hypertension Initiative (MHI) quality improvement program addresses hypertensive disorders of pregnancy and increases monitoring in both the intrapartum and the postpartum periods.  It consists of a bundle of three evidence-based interventions in response to critical, sustained elevated blood pressure.  The program demonstrated a 25.8% reduction in the rolling 4-month rate of eclampsia and a 16.1% reduction in non-hemorrhage-related severe maternal morbidity.  

4.    Emagine Solutions Technology – Tucson, AZ

Program/Focus: The Journey Pregnancy

The Journey Pregnancy’s platform of technologies for pregnancy and postpartum care has been developed to improve maternal health outcomes.  With their patient app (The Journey Pregnancy), provider software (The Journey Clinic), and handheld ultrasound (VistaScan), they have created data-driven technologies to help make pregnancy safer through platforms that streamline monitoring with providers during pregnancy and postpartum.  Nearly half of the users of the patient app stated that using the platform made them feel both more safe and more aware of their health during pregnancy.

5.    Lehigh Valley Health Network – Allentown, PA

Program/Focus: Continuous Ambulatory Remote Engagement Services (CARES)

Continuous Ambulatory Remote Engagement Services (CARES) began as a remote monitoring program for patients with congestive heart failure and was extended to address postpartum preeclampsia at two of their largest sites in April 2020.  The inclusion of postpartum women resulted in rates of blood pressure monitoring increasing from under 50% to 76% in their patients. 

6.    New York City Health + Hospitals – Manhattan, NY

Program/Focus: Hypertension Treat to Target Program (T2T)

Hypertension Treat to Target Program (T2T) launched in 2018 to link women with hypertensive disorders of pregnancy to primary care for postpartum hypertension management.  Of the 90 women referred to primary care hypertension management to date, 57% have been successfully engaged in care, a four-fold increase over the period before the program was launched, and 92% of these women have achieved blood pressure control.  

7.    Novant Health – Charlotte, NC

Program/Focus: Novant Health Hypertension Challenge

The Novant Health Hypertension Challenge initially focused on the development and implementation of tools used in the acute care setting to identify and treat severe hypertension during pregnancy.  The Novant Health Hypertension Challenge later launched a pilot program to identify and manage hypertension during pregnancy.  This included virtual patient visits and the implementation of remote patient monitoring providing daily surveillance of blood pressure values.  Data was collected via a smartphone or tablet, enabling the exchange of patient data through a secure portal and the electronic medical record.  The pilot was successful in improving rates of identifying hypertension in pregnancy and ensuring follow-up from 15% in the control group to 27% in their program.

8.    Nurse-Family Partnership – Denver, CO

Program/Focus: Client-Centered Nurse Home Visitation to Control Pregnancy-Induced Hypertension

The Client-Centered Nurse Home Visitation to Control Pregnancy-Induced Hypertension program resulted in 35% fewer cases of pregnancy-induced hypertension among those with social and economic inequities and 18% fewer preterm births in comparison to non-participants.  They have a national network of over 270 local agencies that operate Nurse-Family Partnership in over 775 counties across 40 states, the U.S. Virgin Islands, and several Tribal Nations, spanning rural, urban, and suburban settings.  Their expansion efforts have included expansions in 15 states that increased their service capacity to reach 1,500 new families with 62 nurses and recent implementations in five states that increased their service capacity to reach 475 new families with 26 nurses.

9.    Ochsner Health – New Orleans, LA

Program/Focus: Connected Maternity Online Monitoring (MOM)

Connected Maternity Online Monitoring (MOM) evaluated the effectiveness of their digital medicine program to increase monitoring of blood pressure during pregnancy and the postpartum period, specifically for Black patients and those in the rural population.  Black patients enrolled in Connected MOM had a statistically significant increase in blood pressure measurements during pregnancy and the postpartum period, with participants measuring an average of 24 blood pressure measurements compared to 15 in the control group. 

10.    Preeclampsia Foundation – Melbourne, FL

Program/Focus: The Cuff Kit

The Cuff Kit program launched in 2020 to enable self-monitoring of blood pressure for women at the highest risk of developing a hypertensive disorder of pregnancy with fewer resources to procure their own blood pressure monitors, which resulted in daily blood pressure readings being recorded by 68.4% of participants.  The Cuff Kit enables providers to respond to indications of gestational and postpartum hypertension more rapidly.  To date, the program has distributed over 20,500 kits working with 181 facilities in 24 states.  Since Phase 1, this represents a 30% increase in distribution and includes a major initiative with the state of Missouri to address racial and rural disparities.

11.    University of Chicago – Chicago, IL

Program/Focus: STAMPP HTN: Systematic Treatment and Management of Postpartum Hypertension

STAMPP HTN: Systematic Treatment and Management of Postpartum Hypertension
brings together a series of evidence-based interventions, including home blood pressure monitoring and telehealth visits, to improve and standardize the clinical care of women with postpartum hypertension.  STAMPP HTN improved the rate of postpartum follow-up visits from a baseline of 29.9% to 76.3% among Black women and eliminated racial disparities in postpartum care.  The program now serves as the standard of care at the University of Chicago Medical Center. 

12.    University of Michigan – Ann Arbor, MI

Program/Focus: Michigan Home Early Alert Remote Tele-monitoring (MI-HEART)

Michigan Home Early Alert Remote Tele-monitoring (MI-HEART) enhanced their remote monitoring efforts using services such as free blood pressure cuffs, blood pressure logs, phone check-ins, telehealth and in-person visits, and lifestyle counseling and a comprehensive care team of nurses, physicians, and midwives.  Daily blood pressure readings were achieved in the first ten days postpartum in 88.6% of their participants. 

13.    University of Pennsylvania – Philadelphia, PA

Program/Focus: Heart Safe Motherhood (HSM)

Heart Safe Motherhood (HSM) uses text messaging to monitor postpartum hypertension, providing automated reminders to send readings to providers and real-time patient feedback based on reported blood pressures.  Using this approach, blood pressure monitoring increased from a baseline of 43.7% to 92.2% in the first 10 days post-delivery among participants.  Additionally, hypertension-related admission decreased from 3.9% to 0% in participants. Since its inception as the standard of care at the Hospital of the University of Pennsylvania, HSM has expanded and is now implemented at all 5 Penn Medicine birthing hospitals.  Nearly 14,300 patients have enrolled across all sites with over 189,000 blood pressures received through the platform.  Additionally, HSM has been implemented at other birthing hospitals in the city of Philadelphia, with continued high patient engagement with blood pressure monitoring and reduction in adverse postpartum outcomes.

14.    University of Wisconsin – Madison, WI

Program/Focus: Staying Healthy After Childbirth (STAC)

Staying Healthy After Childbirth (STAC) is remote monitoring program for postpartum hypertension that resulted in an increase of blood pressure monitoring in the ten days following discharge from 60% to 94%.  The program’s sustainable approach utilizes telehealth support from a dedicated team of health professionals.  STAC serves around 1,500 patients per year in the immediate 6-week postpartum period and is dedicated to advancing postpartum hypertension research to improve equitable care delivery and participation.  

15.    Valleywise Health – Phoenix, AZ

Program/Focus: Outpatient Telehealth and Remote Blood Pressure Cuffs to control Hypertensive Disorders of Pregnancy

Outpatient Telehealth and Remote Blood Pressure Cuffs to control Hypertensive Disorders of Pregnancy focuses on the treatment of patients with severe hypertension.  Recent data shows that 99% of women with severe hypertension are treated with medications within an hour at their facilities.  Working in partnership with the Arizona Alliance for Innovation on Maternal Health program, they are developing metrics for early postpartum follow-up that aim to reduce the rate of severe maternal morbidity associated with hypertensive disorders of pregnancy by 20% in participating hospitals over a period of 18 – 24 months.  This program demonstrated that short-term blood pressure follow-up appointments are scheduled in more than 90% of patients discharged with a hypertensive diagnosis.