Waiting room blood pressure monitor

Identify More Hypertensives With A Waiting Room Blood Pressure Monitor

Guidance on preventing cardiovascular disease (CVD) was originally published in 2019 and was updated this year. Optimal treatment of AF, high blood pressure and raised cholesterol is highly effective in preventing CVD events.

Over 40% of people with high blood pressure remain undiagnosed and of those diagnosed with high blood pressure, only 67% are optimally managed.

How do we diagnose and manage more effectively?

GP Practices are encouraged to actively screen patients and seek out hidden hypertensives. To the average practice this could mean hundreds of extra appointments for a simple blood pressure measurement.

They need help in the form of the easy to use, clinically validated A&D Medical TM-2657P waiting room blood pressure monitor.

Originally the idea of allowing patients to measure their own blood pressure was greeted with scepticism by some clinicians, but practice managers were quick to see the advantages.

Ideally located in a quiet corner of the waiting room, this type of monitor is designed for professional high volume use and automatically prints a reading, with the date and time, on a small slip of paper.

The patient usually shows this reading to the doctor or nurse at the beginning of the consultation and if the readings are too high or low they can then re-measure. In some practices patients hand results to a member of the reception team, who record it electronically for later review.

For practice managers, they offer good management and effective use of resources freeing clinical staff for other roles where they may be better utilised. Some practices report they ‘save’ up to 100 appointments per month on average.

For patients the feedback is positive and the monitors promote understanding and compliance.

Recently we have been involved in a couple of projects looking to target patients who don’t visit a GP regularly or have access to another healthcare provider. TM-2657P blood pressure monitors have been placed in public access buildings like Libraries and Pharmacies.

They have identified new undiagnosed hypertensives with elevated blood pressure and helped manage existing hypertensive patients promoting medication compliance.

PMS Instruments. Expertise, Experience and Trust for service, calibration and support.

These are the key words our customers associate with PMS Instruments, as well as being the fundamental foundations of our calibration and service department.

Back in 2016 I posted an article with a picture of an A&D Medical TM-2655P waiting room blood pressure monitor that had recorded a staggering 103,366 readings since we originally supplied it in 2004!

Since then, we have calibrated and serviced a number of A&D Medical waiting room blood pressure monitors that have recorded in excess of one hundered thousand readings!

At PMS Instruments as an ISO-9001 Quality Assured company we keep detailed service and calibration records for every item of equipment we service and repair.

What’s the secret of this reliability and low cost of ownership?

I am convinced it is regular, preventative and routine servicing by PMS Instruments which extends the ‘in service’ life of the monitors and prolongs the investment our customers make in their equipment.

How does the service you get from PMS Instruments differ?

The A&D Medical TM-2655P and TM-2657P waiting room blood pressure monitors are specialist instruments, requiring specialist knowledge and test equipment.

With every service and calibration PMS Instruments carries out, each monitor is subjected to an approved individual ISO-9001 quality assured Work Instruction. This comprises a series of up to 70 detailed steps our service engineers must follow, and which the product must pass, in accordance with the manufacturer’s service manuals.

You get so much more from PMS Instruments than the basic 10 minute on site functional test some companies offer.

Our popular Fixed Price Service and Support Plan includes:

Annual calibration of your device and detailed calibration certificate issued.
Priority unlimited telephone and technical support.
Fixed price servicing cost.
Fast priority response for all servicing and repairs.
20% discount off non standard service items including pumps
Standard service parts and consumables including filters.
Replacement of the cotton cuff inner.
Supply of premium packing box and material included.
Courier collection and return included.
Priority turnaround time typically 3-5 working days from receipt of equipment.
Inclusive annual service and calibration to manufacturer’s specification.

You get what you pay for…

PMS Instruments’ service and calibration team are certified to ISO-9001 and use only genuine manufacturer approved spare parts.

Depending on the model it can take up to 90 minutes for our Service Engineers to adjust, calibrate and service an A&D Medical waiting room blood pressure monitor and we are the experts at it! Rapid turnaround time means minimum downtime and a full service and calibration certificate is issued.

Not convinced and still want to use another company?

Can the company you use tell you how many readings your waiting room blood pressure monitor has taken during its lifetime? If they can’t schedule your service and calibration with PMS Instruments and we will.

Save time and money one measurement at a time

At around £1,500.00 is the A&D TM-2657P waiting room blood pressure still worth the money?

Self patient blood pressure measurement devices like the A&D TM-2657P are not new and there are now several hundred in use in the UK since they were first introduced by PMS Instruments 17 years ago in 2002.

Sited in the waiting room, for many Practices they are an integral part of their long term medical conditions clinics allowing them to work smarter, not harder, whilst helping patients take ownership of their conditions and play a more active role in their treatment.

A number of GP practices have adapted established protocols whereby patients pass their blood pressure results to the reception team and are then advised as to whether there is a need for further clinical follow up.

The protocol needs to be easy to follow and comprehensive to ensure that the receptionist is taking no responsibility for a clinical decision. When implemented correctly, after suitable training the process works very well.

Why is all this relevant to Primary Care and the NHS?

When this type of service is introduced anecdotal evidence from PMS Instruments GP customers suggests that waiting room BP monitors are used by up to 240 patients every month and only 80 of them require any further intervention. This represents a potential “saving” of over 160 face to face GP clinical appointments.

Let’s do some maths!

According to NHS England, the average GP appointment costs £30 so in the example above that’s a saving of £4800 to the NHS every month.

So the payback period in terms of time saved and the initial £1500 cost of the monitor is established but what are the other benefits?

It’s about time.

According to a report published in Pulse in August 2019, over half of GPs have said the average waiting time for non-urgent appointments at their practice is now over two weeks.

Anything that can help reduce this must be a good thing and waiting room blood pressure monitors like the TM-2657P can.

With the protocol above Doctors and nurses who want to monitor a patient’s blood pressure ask the patient to use the waiting room BP monitor and they only need to see a Doctor if their readings move out of an agreed range. Patients can do this at any time the practice is open freeing up valuable appointment time.

Nurses who run chronic disease clinics can also ask patients to monitor their blood pressure before coming to their clinic. Apart from saving nursing time it gives an immediate focus to the consultation.

Public Health England and NHS England have agreed ambitions and a goal over a 10 year period to improve the detection and treatment of high blood pressure with the following targets

80% of the expected number of people with high BP are diagnosed by 2029
80% of the total number of people diagnosed with high BP are treated to target as per NICE guidelines by 2029

How do we achieve these objectives when Primary Care is already overstretched?

In this instance the technology, in the form of waiting room BP monitors, already exists we just need to encourage wider adoption and not be afraid to adopt new approaches.

Time is money as the saying goes and the A&D TM-2657P saves time and money one measurement at a time.

Are we doing enough to diagnose high blood pressure?

How often do you “Think BP”?

Did you know that in the UK alone, according to the British Heart Foundation (BHF), there are an estimated 7 million people with undiagnosed high Blood Pressure who don’t know they are at risk. Over 24% of people in England are estimated to have high Blood Pressure. At least half of all heart attacks and strokes are associated with high BP and it is a major risk factor for chronic kidney disease, heart failure and cognitive decline.

If these are the challenges facing Primary and Secondary Care the question is what can GP Practices, Hospitals and Clinical Commissioning Groups do to diagnose more patients with high blood pressure?

Can we do BP better and “Think BP”?

The BHF Guidance recommends key areas and stresses that clinicians should “Think BP” at every opportunity. I have separated their recommendations into a couple of key areas below where I think existing technology available from PMS Instruments could help.

Think BP in the Waiting Room— Consider giving patients access to a self-test blood pressure station in GP waiting rooms and Hospital Outpatient clinics. Professional, clinically validated monitors like the A&D Medical TM-2657P are designed for high volume use have been popular with GPs for many years and are now being used in Hospitals. They save both time and money in the long run and especially in a Hospital setting like a Renal Unit free up members of staff for other clinical duties.

Think BP during a consultation-Think BP and increase opportunistic screening in your GP Practice or Hospital. Make blood pressure testing routine for all patients attending clinics such as Renal, Sexual Health, Asthma, COPD, Diabetes, weight management, smoking cessation and other clinics. Patients can record their blood pressure in the GP or Hospital waiting room before they attend the clinic. The printed results can then be handed to the clinician during consultation saving time and staff resources.

For a trial, demonstration or to find out more about the TM-2657P call us today on 01628 773233.

PMS Instruments. Expertise, Experience and Trust for service, calibration and support.

These are the key words our customers associate with PMS Instruments as well as being the fundamental foundations of our calibration and service department.

I recently posted on Facebook a picture of an A&D Medical TM-2655P waiting room blood pressure monitor that had recorded a staggering 103366 readings since we originally supplied it in 2004!

Having visited the R&D centre in Japan I know the engineering quality, research and development that A&D Medical put into the design and manufacturer of their products but was intrigued and asked one of our service engineers to give me the service history of the monitor over the last 12 years.

We keep detailed service and calibration records for every item of equipment we service and repair. The monitor had a new cuff mechanism fitted in 2007 which we replaced under warranty but other than that had had no other parts fitted just regular, routine and preventative maintenance.

What’s the secret of this reliability and low cost of ownership?

I am convinced it is regular, preventative and routine servicing by PMS Instruments which extends the in service life of the monitors and prolongs the investment our customers make in their equipment.

Why do I think this? There are any number of medical companies that visit GP surgeries in the UK offering to service and calibrate a wide range of blood pressure monitoring equipment. That may be the case but the TM-2655P and TM-2657P waiting room blood pressure monitors are specialist instruments, requiring specialist knowledge and test equipment.

So what are you actually getting from us and how does our service differ?

With our service and calibration service each monitor is subjected to an approved individual ISO-9001 quality assured Work Instruction. This comprises a series of up to 70 detailed steps our service engineers must follow and which the product must pass in accordance with the manufacturer’s service manuals. You get so much more from PMS Instruments than the basic 10 minute on site functional test some companies offer.

You get what you pay for?

Not convinced and want to use another company?

To ensure you are getting a proper and professional service for your A&D Medical waiting room blood pressure monitor and compare like for like ask your current service provider these questions.

Are you authorised by A&D Medical to work on this equipment?
Have the service engineers working on your equipment been on an A&D training course?
Do you follow a preventative service and maintenance schedule?
Do you perform an internal inspection of the equipment?
Do you check and replace routine original service parts?
Do you use an A&D Medical BP Checker?

Was it yes to all of these?

I was happy for the customer that their A&D Medical waiting room blood pressure monitor had provided so many years of reliable and trouble free service.

Has your TM-2655P monitor reached 100000 + readings during its lifetime yet? If your current service company can’t tell you call us on 01628 773233 and we will.

The secret by the way is Test Mode 41 or is it 42!

Know Your Numbers Week 12 – 18th September

The 12^th to the 18^th of September this year sees the return of ‘Know your Numbers’, a Blood Pressure UK run awareness campaign to promote blood pressure testing. KYN was first launched in 2001 and has since gone on to encourage around 1.5 million people to have their blood pressure checked. The idea is that we should all know our blood pressures like we know our height and weight.

For me, that’s a great analogy. If you weigh yourself and realise you’ve put on a few pounds, then you might start eating a bit differently or moving a bit more. The difference, however, is that with weight gain you have a visual clue before anything else. Blood Pressure is only known once tested, but knowing those figures and tracking the changes could one day save your life.

As part of KYN week, ‘Pressure Stations’ will be setup all around the country at the more obvious venues such as GP surgeries, hospitals and health clubs, but also shopping centres and supermarkets, so it should be easy for everyone to get checked out.

At P.M.S (Instruments), we think this is a great initiative, and hope it does it a lot of good, but we can’t forget that we’re here to supply both surgeries with the equipment they need and also those at home or in the private healthcare sector. With that in mind, we’d like to share some news on two great new products.

The A&D TM-2657P is the follow up to the TM-2655P, popular with GPs as it saves consultation time. This is particularly useful at this time of year when it comes to screening elderly patients who are having the flu jab in large volumes. My favourite new feature of this machine is the added value of the Irregular Heartbeat Indicator (IHB) function – a highly useful new feature. Check out the write up below for some more specs!

The other great new Blood Pressure Monitor is the A&D UA-767-S, which is the latest in a generation of models of the same name. This is a really portable BPM, which makes it perfect for either home use, those who are regularly out and about on home visits or just in the surgery. Another brilliant bit of kit from A&D, again, check below for full specs!

Here at PMS, we’re proud to have a 40 year plus history of supplying technology you can trust. We’ve been the main A&D UK distributer since 1990 (A&D have been making Blood Pressure Monitors since 1979) so we can guarantee the best equipment and a genuine pedigree. For is, this is the perfect marriage to support the upcoming Know Your Numbers week.

A&D TM-2657PA&D TM-2657P – For Waiting Room Use

Key features

User-friendly with small footprint
BHS AA grade clinical validation
Simple one-touch fully automatic measurement
Accurate and reliable Torque Controlled Belt drive Method
Antibacterial inner arm cuff cover
Easy load paper tray
Reliable high speed printer with easy paper replacement
Irregular Heart Beat (IHB) indicated on printout

The TM-2657P is the latest waiting room blood pressure monitor from A&D Medical. It builds on the speed, reliability and accuracy of the previous TM-2655P, which it replaces, but now features a new ergonomic, modern, compact design. The new integrated armrest helps ensure the patient’s arm is comfortable and in the correct position during a measurement.

A new antibacterial arm cuff cover is also now fitted as standard with the TM-2657P. Designed and engineered in Japan, the new TM-2657P has a faster printout speed and offers added optional connectivity features including Bluetooth.

The “Torque Controlled Belt drive Method” (TCBM) cuff mechanism in the TM-2657P provides sophisticated automatic cuff size adjustment, ensuring the arm is positioned correctly for accurate high speed measurement, first time, every time.

With a centrally located simple one-button operation, it can be used on children (13 years or above) and adults with either the left or right arm. After the reading, the results are output to the inbuilt thermal printer with the date, time systolic, diastolic and pulse rate clearly displayed. New printing options also permit the inclusion of a barcode or QR code on the print out.

The printout will also display (if present) an irregular heartbeat symbol. An irregular heartbeat is defined as a heartbeat that varies by 25% from the average of all heartbeats during the blood pressure measurement.

Like the previous model, the TM-2657P looks set to be popular with GP Practices looking for a clinically validated, easy to use professional waiting room blood pressure monitor.

Key features

Compact size and weight (140(w) x 60(h) x 105(d) mm weighs (245g) ex batteries
Advanced Oscillometric method for hospital accuracy
60 reading memory with average
Correct cuff fit and movement detector
Irregular heartbeat indicator with frequency detected
WHO blood pressure classification index
European Society of Hypertension International Protocol clinical validation
Five- year warranty
Battery or mains (optional extra) operation

The frequency of IHB (Irregular Heart Beat) detection is divided into different grades and shown by icons.

0-24% : No Indication
25-49% : Grade 1
50-74% : Grade 2
75-100% : Grade 3

The latest A&D Medical UA-767S builds on the popularity, accuracy and reliability of the original UA-767 series but it adds additional new advanced features. It is a popular upper arm blood pressure monitor with a 60 reading memory with averaging function, cuff fit and movement error functions and a simple one-button operation. This model features a new Irregular Heartbeat Indicator (IHB) function, which identifies the frequency of IHB by dividing the number of IHBs by the total number of readings taken to grade the occurrence of IHB accordingly. The more frequent the IHB appears the greater the risk. This feature is for monitoring purposes only. The UA-767S is supplied with a standard 22-32cm cuff. For customers with a larger arm we recommend the UA-767S-W, which has a 22-42cm cuff. It has a proven reliability record and is used extensively in the UK.

Waiting Room Blood Pressure Monitors Rebooted

The new integrated arm rest helps ensure the patient’s arm is comfortable and in the correct position during a measurement. A new antibacterial arm cuff cover is also now fitted as standard with the TM-2657P.

Designed and engineered in Japan, the new TM-2657P has a faster printout speed and offers added optional connectivity features including Bluetooth.

With a centrally located simple one button operation, it can be used on children (13 years or above) and adults with either the left or right arm.

After the reading, the results are output to the inbuilt thermal printer with the date, time systolic, diastolic and pulse rate clearly displayed. New printing options also permit the inclusion of a barcode or QR code on the print out.

Like the previous model, the TM-2657P looks set to be popular with GP Practices looking for a clinically validated, easy to use professional waiting room blood pressure monitor.

PMS algorithm for blood pressure measurement

The CG127 2011 NICE Hypertension guidelines includes generic guidance on the measurement of blood pressure, including the key recommendation that 24 hour ambulatory blood pressure measurement be used before anti-hypertensive treatment is initiated. However out of the entire 317 page document, there is only one 6 page section on measuring blood pressure.

This section focuses on the different ways and methods of measuring blood pressure and the different types of devices available. The question is could the selection of the latest devices streamline the blood pressure measurement process and save time, as well as clinical resources?

Is there a case for developing a suggested PMS algorithm for blood pressure measurement and what form should this take?

Step One Use a Waiting Room BP Monitor

Monitors like the TM-2655P waiting room monitor for patient self-measurement have been available for some time. They are convenient, easy to use and cost effective. They can be effective opportunistic screening devices and may identify patients with undiagnosed Hypertension.

Many also provide additional clinical information such as whether an Irregular Heartbeat is present. Many GP practices utilize them as part of a drop in service as they allow patients to monitor their own BP without making an appointment. This frees up clinicians for other duties. As with any BP monitor, it is important to check the monitor is listed on the BHS web site (www.bhsoc.org). Monitors that measure from the upper arm are recommended.

Step 2 Confirmation with a manual measurement

If it is felt that a reading from a waiting room blood pressure monitor needs clarification, an additional measurement should be taken. The BHS provide “best practice” guidance on the correct way to record blood pressure using an automatic or manual device. Most clinicians will rely on a clinically validated automatic monitor.

Most of these low cost devices like the UA-1010 feature an irregular heartbeat indicator and some have a “Tricheck” feature, which will automatically repeat a measurement three times, in accordance with BHS recommendations.

For patients identified with an irregular heartbeat, non-Mercury manual devices like the UM-101 are available.

Step 3 Use ABPM – The Gold Standard

The cost of ambulatory blood pressure monitors has fallen considerably over the last few years. Like spirometers and ECG machines, the latest models such as the Meditech ABPM-05 feature software that provides automatic analysis of the results for consistent, time saving reporting to NICE Guidelines.