Integrating remote blood pressure monitoring into NHS primary care: a human factors perspective
Open accessAbstract
Background: Hypertension remains a major health burden in the UK, contributing significantly to cardiovascular disease and health inequalities. Although digital health technologies offer opportunities to enhance hypertension management, current NHS pathways face challenges, including inefficiencies in patient monitoring, limited patient engagement, and resource constraints. This study aimed to evaluate integration challenges of remote digital monitoring tools for blood pressure into NHS hypertension care pathways. Methods: An exploratory study combining semi-structured interviews with 14 primary care NHS stakeholders recruited from across England, and a field study at two GP practices. Participants were selected to have either experience or not with digital platforms for remote monitoring of chronic conditions in primary care. Clinical pathway mapping and gap analysis were used to identify inefficiencies in hypertension management and explore digital platforms' potential integration. Results: Eight major gaps were identified, including inconsistent patient engagement, lack of automated identification of at-risk and non-compliant patients, limited access to home monitors, and health inequalities related to digital literacy. Integration of a digital platform addressed several of these gaps by promoting self-monitoring behaviours, improving resource allocation through risk stratification, and enhancing decision-making with continuous patient data. However, barriers such as interoperability issues, workload concerns, literacy disparities, and unclear role responsibilities were noted. Conclusion: Successful implementation requires addressing systemic challenges through targeted training, robust interoperability standards, clearer task allocation, and equity-focused interventions to bridge the digital divide. A human-centred, system-wide strategy is essential to ensure sustainable adoption and maximise the impact of digital innovations in primary care.
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Large-scale implementation of RPM across healthcare delivery organizations remains fragmented and frequently plagued by high attrition rates.
“large-scale implementation across healthcare delivery organizations remains fragmented and frequently plagued by high attrition rates [5,6].”
From Clinical Efficacy and Patient Adherence Hurdles of Remote Patient Monitoring (RPM) Frameworks in Managing Hypertension and Type 2 Diabetes: A Scoping Review (2026) · cites this paper as [5]
The Discussion (Interoperability challenges; page unavailable) describes fragmented IT systems across organisations, and the Results (Challenges and barriers to implementation; page unavailable) describe uneven adoption and patient engagement. These passages support implementation difficulties, but not a claim about large-scale RPM implementation across healthcare delivery organisations or frequent high attrition rates. (LLM, conf=0.82)
Experimental — accuracy not yet measuredContemporary deployment failures of RPM are increasingly attributed to operational and human factors.
“contemporary deployment failures are increasingly attributed to operational and human factors [5,6].”
From Clinical Efficacy and Patient Adherence Hurdles of Remote Patient Monitoring (RPM) Frameworks in Managing Hypertension and Type 2 Diabetes: A Scoping Review (2026) · cites this paper as [5]
The Results section (‘Challenges and barriers to implementation’; page unavailable) identifies workload, digital literacy, role allocation, and system integration as barriers to remote blood-pressure monitoring in NHS primary care. It does not establish that deployments failed or that attribution to operational and human factors is increasing over time; the claim extends beyond the study’s setting. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe high prevalence of automated cloud and server-side uplinks reflects an industry-wide effort to minimize patient compliance burdens by removing active transmission steps.
“The high prevalence of automated cloud and server-side uplinks reflects an industry-wide effort to minimize patient compliance burdens by removing active transmission steps [1,5].”
From Clinical Efficacy and Patient Adherence Hurdles of Remote Patient Monitoring (RPM) Frameworks in Managing Hypertension and Type 2 Diabetes: A Scoping Review (2026) · cites this paper as [5]
The Results (Field study; page unavailable) discuss data-synchronisation problems between a monitoring platform and electronic health records, not the prevalence of automated cloud or server-side uplinks. Searches for automated transmission and patient submission of readings found no passage establishing an industry-wide effort to remove active transmission steps. (LLM, conf=0.76)
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Cited by
Sorted by citations
- Authors
- Micocci, M., Butt, O., Zhou, S., El-Osta, A., Buckle, P., & Hanna, G. B.
- Affiliations
- Imperial College London (GB)
- Corresponding author
- Micocci, Massimo
- Venue
- Frontiers in Digital Health
- Publisher
- Frontiers Media SA
- Published
- 2026-03-05
- Volume
- 8
- Pages
- 1697787-1697787
- ISSN
- 2673-253X (ISSN-L)
- PMC
- PMC12999572
- OpenAlex
- W7133689143
- Cited by
- 1
- References
- 35
- Citations by year
- 2026: 1
- FWCI
- 6.40
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Digital Health (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Omron Healthcare
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- remote blood pressure monitoring, antihypertensive therapy, primary care, digital health technologies, interoperability, digital divide, digital literacy, patient engagement, risk stratification, implementation barriers, human factors, National Health Service
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