Pedia BP, a free smartphone application, was developed to improve evidence-based clinical practice by simplifying the process of interpreting a pediatric blood pressure measurement. We implemented this application in 2 international community-based programs in Haiti and the Dominican Republic. During well-child checks of 389 children, nurse practitioner students observed an increase in the number of initial elevated blood pressure readings. With the use of health care informatics technology, like the Pedia BP program, pediatric hypertension may be better interpreted and ultimately managed.
Due to the lack of access to affordable oral healthcare in outpatient settings, emergency departments (EDs) see unnecessary overuse in providing palliative care for mouth pain. Hospitals across the country are exhausting limited human and fiscal resources on patients seeking relief for non-traumatic oral conditions that could be better managed in nonhospital settings. Community dental clinics offer one strategy for easing the burden on EDs, while simultaneously reducing costs to the system, facilitating definitive care, and minimizing time away from work and home for patients. The expansion of government funding, including comprehensive adult Medicaid dental benefits, to facilitate preventive and restorative coverage for populations in need in outpatient settings would increase access to appropriate care and likely further reduce the tendency for patients to seek dental care in EDs. Targeting of specific high-risk groups (such as low-resourced or minority persons) also would help to remove barriers to care, lessen disparities in access and treatment, and improve equity in oral health in the U.S.
The prevalence of hypertension and pre-hypertension in the pediatric population is increasing. The development of primary hypertension earlier in life increases the chances of cardiovascular morbidity and mortality later in life. Studies have shown that 34 to 38% of children and adolescents with mild untreated hypertension already show signs of left ventricular hypertrophy. Evidence shows that childhood and adolescent hypertension and pre-hypertension are under-recognized due to a number of factors including lack of provider knowledge regarding the National High Blood Pressure Educational Program (NHBPEP) guidelines for diagnosing, evaluation, and treatment of high blood pressure in children and adolescents. Another issue is the complexity of diagnosing HTN in this population that requires utilizing 1,904 variables based on gender, age, and height percentile delineated from the CDC development charts. To more easily detect hypertension in children and adolescents, a Smartphone application, Pedia BP, was designed and developed. The existing tables from The Fourth Report on the Diagnosis, Evaluation and Treatment of High Blood Pressure in Children and Adolescents (NHBPEP, 2005), which contain hundreds of normal and abnormal blood pressure values based on gender, age, and height percentile, were analyzed and streamlined into a much simplified, single user interface Smartphone application. Pedia BP makes it easy to identify abnormal blood pressure values in an accurate and timely manner and resides on the mobile device so Internet access is not required and can be used in any setting. The time saving Pedia BP application, allows the practitioner to quickly follow best practice protocols regarding management of identified issues.
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