Empower Health is a novel social business initiative that brings together partners and innovative technology to create a unique end-to-end model of care for underserved patients with hypertension and/or diabetes. Empower Health provides integrated, facility-level and community-level tools and service offerings to improve disease awareness, support screening and referral activities, reduce the burden of disease, and improve the efficiency of managing hypertension and diabetes for both patients and clinicians.
The Empower Health model consists of a mobile device, an automated blood pressure machine, a glucometer, and a novel proprietary software application — combined in a unique platform for efficient screening and longitudinal management of a patient cohort. Leveraging the model, physicians provide patients with tailored management plans. Patients can access regular blood pressure and blood glucose checks at community-partner locations or at home where they receive real-time feedback on their measurements. On the mobile application, clinicians can view patient data, provide direct patient feedback on their conditions via SMS, and write electronic prescriptions — accessible through participating pharmacies.
In 2016, Medtronic Labs completed a feasibility pilot with 150 known hypertensive patients. After 6 months of recommended weekly BP monitoring, systolic blood pressure decreased significantly (p<0.01) in both the overall cohort (-4.7 ± 18.7 mmHg) and in the uncontrolled subgroup (-15.2 ± 17.6 mmHg). The proportion of the population with uncontrolled hypertension decreased from 39% to 27% (p=0.01).1 After completing the needs assessment work and feasibility pilot, the Empower Health team commercialized this model in East and West Africa in 2017. To date, more than 100 healthcare workers and providers have received training on the software and clinical protocols, resulting in the enrollment of more than 1100 individuals with hypertension. Encouragingly, for those who have been enrolled and monitored for at least 3 months, clinically significant reductions in BP are being observed.
The burden of non-communicable diseases (NCDs) is increasing in sub-Saharan Africa. By 2050, the prevalence of hypertension is expected to expand to 33% of the population. In Ghana, nearly 30% of the population has hypertension, but only 2.8% of those are controlled adequately with pharmacological management and lifestyle modifications.2 In Kenya, it is estimated that approximately 24% of the adult population has hypertension, with only 4% having their blood pressure adequately controlled.3 The International Diabetes Federation estimates that the prevalence of diabetes in Ghana and Kenya at 2% and 3.6% respectively, and are on the rise. It is also believed that up to two-thirds of diabetics may be undiagnosed.
While many programs focus on diagnosing hypertension and diabetes, management of these chronic diseases has received less attention. As the world seeks to make progress towards the UN’s Sustainable Development Goals and as health systems look for technology and tools to achieve Universal Health Coverage, tremendous opportunity exists to increase awareness through screening, reduce complications of hypertension and diabetes, and lower the burden of chronic care management for clinicians, patients, and health systems.
Hypertension, 2018, Vol 7 (3): 257.
Hypertension, 2004 May: 43(4): 1017-22. E-pub 2004 Mar 22.
Kenya STEPwise Survey for Non-Communicable Diseases Risk Factors 2015 Report.