Half a decade ago, long-distance trucker David Jesse's blood pressure was 160/110 and he was in jeopardy of losing his commercial driver's license if it didn't get lower.

Five years later, the blood pressure is 120/80. Jesse has been in a maintenance phase for four years with a better diet, more exercise, a nurse wife who remotely keeps tabs on his health, and software that enables him, his wife and physician to continually track readings. "I now am on an almost non-existent dosage of hypertension medicine," he says.

Now 48 years old with a home in Bedford, Ohio, that he gets to for a few days each month, Jesse initially was diagnosed with pre-hypertension and put on medication. But he was taking the medication at night and having blood pressure tests done in the morning, which contributed to the high readings.

After joining a disease management program at the Cleveland Clinic, Jesse's new physician noticed his potassium levels were low, which may have been the cause of his hypertension. Now on the right medication, he takes blood pressure readings each night right before taking the medication for more consistent readings. A cell phone-sized device, called HealthPAL from Scottsdale, Ariz.-based MedApps Inc., wirelessly collects readings from Jesse's blood pressure monitor. The readings are transmitted to Jesse's personal health record, which Cleveland Clinic offers patients, and his wife and physician have authorized access to the PHR. If spikes in blood pressure show up, they'll ask about his diet, and stress and sleep levels.

Jesse has become an advocate of remote patient monitoring applications such as HealthPAL and of personal health records. He has piece of mind knowing that if any medical emergency comes up on the road, that his PHR can be made available to physicians who need it. "It gives a better comfort of medical care."

He encourages truck and bus drivers, railroaders and pilots to use such technologies, as the federal government sets more stringent health regulations for these occupations. The technologies are easy to use, he says. It's trying to eat right while always on the road that's tough but doable.

Jesse also urges other hospitals to copy Cleveland Clinic and offer portable monitoring applications and PHRs for highly mobile individuals and seniors at home, particularly in remote regions. "You can take care of a good portion of the population, but a lot will still get left behind."

--Joseph Goedert


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