Integrating remote blood pressure monitoring into NHS primary care: a human factors perspective

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.