Understanding the Financial Benefits of Automatic Blood Pressure Devices in Primary Care

A patient in a primary care clinic has their blood pressure measured by a clinician.

Author: Dr. Steven A. Yarows, MD, FACP, FASH, FAHA – Clinical Professor of Internal Medicine, Michigan Medicine

Location: Chelsea Family and Internal Medicine, Chelsea, Michigan, USA

Practice Overview:
Chelsea Family and Internal Medicine operates as part of Integrated Healthcare Associates (IHA), a large multispecialty medical group headquartered in Ann Arbor, Michigan. With approximately 70 practice sites and over one million annual patient visits, IHA stands among the largest medical group networks in the state.

Introduction

Primary care offices handle a steady stream of patients every day, making efficiency a critical factor in keeping operations smooth and controlling costs. In 2015 alone, out of roughly 922.6 million total physician visits, more than half (53%) were with primary care physicians.¹ The most frequent reason for these visits? Hypertension.²

When practices consider purchasing new equipment, cost-effectiveness often tops the list of concerns. This naturally raises the question: for a task performed at virtually every visit — taking vital signs — is there a measurable advantage in switching from traditional manual tools to automated devices?

A quality-improvement study conducted in a Michigan primary care clinic set out to explore exactly that, focusing on the potential cost savings and workflow benefits of using an automatic blood pressure monitor.

Study Overview

Dr. Steven Yarows of Michigan Medicine compared two blood pressure measurement methods in his practice — one manual, the other automatic — and examined the time and cost differences between them.

Over the course of 43 days, six medical assistants took 827 patient blood pressure readings.

The first 411 measurements were done using a Welch Allyn Connex® automatic vital signs monitor.
The next 416 readings used a Tycos® wall-mounted manual sphygmomanometer.

Patient Profile:
The average patient age was about 64 years, with a higher-than-average BMI. This demographic faces greater risks for hypertension, cardiovascular disease, stroke, and related complications. For such populations, having quick, accurate, and consistent blood pressure readings is especially important for diagnosis and ongoing care.

Key Findings

Time and Cost Advantages

Manual readings with the wall-mounted gauge averaged 58.6 seconds each. In contrast, once staff became accustomed to the Welch Allyn device, the automated method averaged just 29.3 seconds per reading — effectively cutting measurement time in half.³

Dr. Yarows calculated the value of time saved by factoring in medical assistant wages, which averaged $21.37 per hour (about $0.01 per second). Using this, the manual process cost roughly $0.34 per reading, compared to $0.17 for the automated process post-learning curve — a savings of $0.11 per patient.⁴

While this may seem small at first glance, the volume of measurements in a typical primary care setting changes the picture dramatically. In Dr. Yarows’ practice — with more than 25 patients per day, 5 days a week, 52 weeks a year — those $0.11 savings add up to over $1,000 annually.⁵

Looking Ahead

Enhanced Proficiency Over Time

During the early stages of the study, the automatic method took longer — averaging 39.8 seconds — but as staff grew more familiar with the device, times dropped to 29.3 seconds.

Return on Investment (ROI)

The study projected that an automatic device could potentially pay for itself within a single year.⁶ Additional gains could be realized if the device were integrated with the practice’s electronic medical records (EMR) system, further streamlining workflows and reducing transcription errors.

Freeing Up Clinician Time

Manual blood pressure measurement is repetitive and can consume a surprising amount of a clinician’s career — Dr. Yarows estimates he has spent over 500 hours performing them. Even shaving off a few seconds per patient could result in significant time savings over the long term.⁷

Improved Patient Flow

Faster measurements also mean shorter “rooming” times, which is valuable in clinics with limited exam space. Increased turnover in each room could help practices see more patients or reduce wait times.⁸

Conclusion

In this study, the automatic oscillometric method proved faster and more cost-effective than traditional manual readings, with staff becoming quicker and more adept over time. Manual measurement showed no comparable improvement.

Automatic devices also bring added clinical value. For example, the Welch Allyn Connex Vital Signs Monitor includes blood pressure averaging technology, which research shows can reduce hypertension misdiagnosis by up to 56%.⁹ This not only improves diagnostic accuracy but can also influence better treatment decisions.

Considering the potential savings, workflow improvements, and diagnostic benefits, the study suggests that standardizing automatic blood pressure measurement in primary care could be a worthwhile move for practices nationwide.

References:

CDC. Ambulatory Care Use and Physician Office Visits. 2017. https://goo.gl/3JdzAT
2–8. Yarows SA. What is the Cost of Measuring a Blood Pressure? Ann Clin Hypertens. 2018; 2: 059-066. https://doi.org/10.29328/journal.ach.1001012
Robert Smith, MD. Blood Pressure Averaging Methodology: Decreasing the Risk of Misdiagnosing Hypertension