VA health care staff members are concerned about matters of the heart – high blood pressure, to be exact. In 2018, medical staff diagnosed more than a third of Veterans with high blood pressure. That makes it the most common chronic medical condition among Veterans.

At the VA North Texas Health Care System in Dallas, Remote Patient Monitoring-Home Telehealth Care Coordinators found an innovative way to tackle this problem. They organized a virtual educational symposium for Veterans and their caregivers to empower Veterans to improve their own health outcomes. The American Heart Association (AHA) took notice and recognized them for their efforts.

Care Coordinators Annie Joseph, Anney Mathukutty, Shahin Monsef and Daisy Thomas organized the virtual symposium because they saw a need for it at VA North Texas.

Four in five Veterans enrolled in the system’s Remote Patient Monitoring – Home Telehealth program have high blood pressure. This program enables Veterans to receive care remotely.

However, the staff noticed that these Veterans and their caregivers didn’t know how to manage the condition at home. This is a problem because high blood pressure puts the Veteran at risk for heart disease and stroke, two of the leading causes of death in America.

Three sessions of coaching, instruction and hands-on practice

Veterans and caregivers attended the virtual symposium each Wednesday for three weeks in October 2020. In the first session, an American Heart Association representative provided an overview of high blood pressure. In the second session, a clinical pharmacy specialist shared information on blood pressure medications. In the final session, a nutritionist coached participants on “becoming sodium savvy.”

The symposium taught Veterans and their caregivers how to manage their blood pressure at home.

Thirty-five Veterans and their caregivers attended the sessions. Fifteen nurses also participated.

Each interactive session included opportunities for discussion, Q&A sessions, and polling before and after to assess what attendees learned. Medical experts shared videos on the correct technique to check blood pressure at home and explanations of the different medications used to treat high blood pressure.

There were also demonstrations on how to interpret the nutrition labels of common groceries to help adopt a low-sodium lifestyle.

“With a little bit of instruction, coaching and hands-on practice, the Veterans were motivated to attend the sessions. And they were engaged throughout,” said Thomas.

Veteran responses overwhelmingly positive

After the symposium, the Care Coordinators checked in with attendees for additional feedback. The responses were overwhelmingly positive. They not only learned about high blood pressure but they also went on to make lifestyle changes to improve their health.

One Veteran wrote, “This education was effective and helped me make lifestyle changes with nutrition and regular exercise. I learned about avoiding smoking, limiting the amount of alcohol consumed and creating a healthy life balance in the midst of a heavy schedule.”

“Even my family members were involved in learning as they help prepare meals and do grocery shopping,” wrote another Veteran.

AHA awards team gold status for symposium

The virtual symposium was just the Remote Patient Monitoring-Home Telehealth team’s latest effort to help Veterans control their blood pressure. The team gathered a year’s worth of data from their efforts. Mathukutty presented it at AHA’s 2020 Texas Hypertension Control Summit Series.

AHA awarded VA North Texas gold status, which recognizes practices for achieving 70% or greater blood pressure control among adult patients.

“The symposium was an effective way to educate, increase awareness of treatment, and achieve optimal knowledge to control high blood pressure among Veterans and caregivers,” Mathukutty said. “We were able to transform the nursing practices to improve the patient outcome.”

VA North Texas also received a certificate of recognition from AHA’s “Check. Change. Control. Cholesterol” program. The certificate was for its commitment to improving quality of care by improving awareness, detection and management of cholesterol by educating and empowering patients with evidence-based information and tools.

There is a link between high blood pressure and high cholesterol. Too much cholesterol in your blood can create a fatty buildup on the walls of your arteries, making it harder to pump blood through them and raising blood pressure.

Next: COPD, heart disease, diabetes

The team members plan to continue educating Veterans about blood pressure through virtual symposiums. They also plan to expand into other health education opportunities such as chronic obstructive pulmonary disease, congestive heart failure, and diabetes.

“The sky is the limit,” said Thomas. “There’s so much we can do through telehealth. Home telehealth is an amazing program that has changed the lives of many Veterans – and saved the lives of many Veterans, too.”

All VA medical centers have Remote Patient Monitoring – Home Telehealth Care Coordinators. Registered nurses often are coordinators. Social workers and registered dietitians also can be coordinators.


Gwen McMillian is a communications specialist with the VA Office of Connected Care.

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