Reducing preventable ER visits

Your blood pressure, safely managed from home.

Serene Pulse is a low-friction triage platform that helps older adults monitor blood pressure through simple text messages and phone calls — connecting them to the right care before an ER visit becomes necessary.

Request a Pilot See How It Works

SMS

Phone / IVR

BPConnected Devices

An elderly woman comfortably checking her blood pressure at home while looking at her phone

✓

138/84 — Safe Range

Keep taking your meds. We're here if you need us.

The Problem

Preventable ER visits are a crisis

Uncontrolled hypertension drives a massive share of avoidable emergency department utilization among older adults, costing billions annually.

of adults 60+ have hypertension

NHANES 2021–2023

treat-and-release ER visits per year

AHRQ HCUP 2021

average ER cost for seniors (65+)

AHRQ HCUP 2021

ER visits per 100 people ages 75+

CDC NHAMCS 2022

How It Works

Simple as a text message

No complicated apps. No passwords. Just a phone number that becomes your personal blood pressure safety net.

Report your reading

Text or call a single number with your blood pressure reading. No app required. Just send something like "138/84 feeling ok" and our system understands.

Supports SMS, IVR phone calls, and connected BP devices. Confirmation loops ensure accuracy.

Elderly person texting blood pressure reading on a simple phone

Instant triage

Our clinically validated rules engine evaluates your reading in real time. Normal readings get reassurance. High readings trigger a structured symptom checklist aligned with AHA emergency guidance.

Deterministic rules with versioning. Every decision is logged and auditable.

Sample SMS Triage Flow

185/110 headache

I recorded 185/110. Reply YES to confirm or resend the numbers.

YES

Your reading is very high. Sit quietly and rest. Do you have chest pain, shortness of breath, weakness, or vision changes? Reply 1 for YES or 2 for NO.

A nurse will call you within 15 minutes. Rest quietly. If symptoms develop, call 911 immediately.

Right care, right time

If your reading needs attention, a licensed clinician calls you within minutes — not hours. They connect you to telehealth, a same-day clinic visit, or a home health aide, avoiding an unnecessary ER trip.

Urgent callbacks within 5–15 minutes. Medication and transportation barriers are addressed in real time.

A nurse on a headset reviewing patient data on a dashboard

Callback SLA

< 5 min

for critical alerts

Beyond Blood Pressure

We address the barriers that drive ER visits

Uncontrolled blood pressure is often a symptom of deeper barriers — missed medications, lack of transportation, anxiety, or social isolation. Serene Pulse detects these patterns in real time and triggers closed-loop referrals to resolve them.

Integrated with closed-loop referral platforms for SDoH screening, transportation coordination, and community resource connection.

Medication Access

Trigger: Repeated elevation + "out of meds" message

Staff coordinates refill, med reconciliation, and adherence coaching with pharmacy and PCP.

Transportation

Trigger: "Cannot get to appointment" or missed follow-ups

Staff schedules NEMT ride or switches to telehealth/home visit. Closed-loop referral tracking.

Anxiety & Uncertainty

Trigger: Frequent check-ins with normal rechecks

Reassurance messaging, measurement coaching, and optional coaching call to address triggers.

Caregiver Support

Trigger: Patient unable to self-report consistently

Caregiver enrolled as proxy reporter. Receives alerts and coaching alongside the patient.

For Payers & Partners

ER-offset in a box

We are not selling "remote blood pressure monitoring" as a generic feature. We package a ready-made hypertension safety net that reduces avoidable ER utilization for your most vulnerable members — with clear, measurable ROI.

Humana's own analysis shows Medicare Advantage members in value-based care arrangements had 13.4% fewer ER visits and 7.6% fewer hospital admissions. Serene Pulse brings that same proactive model to your hypertensive cohort through the simplest possible interface.

Healthcare executives reviewing ER visit reduction data in a conference room

Reduce ER Utilization

Studies show RPM programs can reduce ER visits by up to 51% and hospital admissions by 59% within six months.

Lower Total Cost of Care

Average treat-and-release ER visit for seniors costs $1,110. Even a 10% reduction across 2,000 members saves over $100K annually.

Improve HEDIS Scores

Directly supports the Controlling High Blood Pressure (CBP) quality measure that CMS and states use to evaluate MCO performance.

Turnkey Deployment

We handle enrollment, device logistics, clinical staffing, and reporting. You provide the member list and we deliver outcomes.

Dual-Eligible Focus

Purpose-built for the highest-cost, highest-need population: older adults with hypertension, multiple chronic conditions, and prior ER use.

Clean Data & Reporting

Monthly outcome reports with baseline vs. post-launch comparisons on ER visits, admissions, BP control rates, and engagement.

Revenue & Reimbursement Paths

Multiple billing and contracting models aligned to your organization's needs.

Model	Description	Timing	Best Fit
PMPM Program Fee	Predictable recurring revenue tied to enrollment, engagement, and outcome targets.	Medium	Primary model for MCO partnerships
SMBP Billing (99473/99474)	Direct fit for manual SMS/phone reporting. Supports small provider pilots.	Faster (monthly)	Provider enablement path
CCM Overlay (99490/99439)	Care coordination wrapper for multi-morbid geriatric patients.	Medium (monthly)	Layered with SMBP for higher ARPU
Shared Savings	Performance-based contracts tied to ER cost reduction vs. baseline.	Slow (end of period)	Phase 2–3 after pilot data

Clinical Safety

Evidence-based triage framework

Our escalation logic is aligned with the AHA/ACC A-I-M framework (Assess, Identify, Modify) and AHA consumer emergency guidance. Every decision is clinician-overseen, logged, and auditable.

Assess

Confirm accurate measurement. Require re-measurement with proper technique (5 min rest, seated, two readings one minute apart).

Identify

Screen for reversible drivers: missed medications, pain, anxiety, sleep deprivation, acute illness. Structured symptom checklist.

Modify

Route to appropriate care level. Ensure outpatient regimen review and follow-up rather than reflexive ER escalation.

Escalation Matrix

Emergency

SLA: < 60 sec auto-response, < 5 min clinician call

Trigger: BP >180/120 + emergency symptoms (chest pain, shortness of breath, neurologic symptoms, vision changes)

System: Advise 911 immediately. Create Red alert. Notify clinician.

Human: Clinician calls within 5 minutes. Caregiver notified if consented.

Urgent Callback

SLA: < 15 min for >180/120, < 60 min for ≥180/110

Trigger: BP >180/120 without symptoms after recheck, or persistent SBP/DBP ≥180/110

System: Prompt rest + recheck. Create Orange alert.

Human: Clinician calls within 15–60 minutes. Schedule outpatient visit.

Same-Day Routing

SLA: Same-day or next business day

Trigger: BP 160–179 systolic or 100–109 diastolic with concerning symptoms, repeated elevation, or medication lapse

System: Create task for pharmacy support or transport referral.

Human: Same-day call or next business day depending on risk factors.

Routine Monitoring

SLA: Automated response

Trigger: BP <160/100 without concerning symptoms, or trending improvement after recheck

System: Reassurance message. Measurement coaching. Adherence prompts.

Human: Optional coaching call. Standard follow-up schedule.

Regulatory Guardrails

HIPAA & Data Security

Full HIPAA compliance from day one. Business Associate Agreements with all covered entities. Minimal PHI in SMS content. Role-based access and immutable audit logs.

FDA / SaMD Boundaries

Guideline-based routing with clinician oversight. No near-term event prediction. No automated "you do not need the ER" statements. Deterministic rules over generative outputs.

Pilot Design

Proof in 12 months

A focused pilot with 1,000–2,000 seniors in a single region, designed to answer two questions: Is it safe? Does it reduce avoidable ER use?

Setup

Months 1–3

Clinical protocol + scripts approval
Vendor contracting + BAAs
Build V1 (SMS + IVR + dashboard)
Staff training + dry runs

Launch

Months 3–4

Soft launch (100–200 members)
Full rollout (1,000–2,000 members)

Operate & Evaluate

Months 4–12

Steady-state operations
Midpoint analysis + protocol tuning
Final evaluation + ROI report

Key Performance Indicators

Enrolled / invited

Enrollment Rate

25–40%

Members submitting 12+ readings/month

Active Engagement

50–70%

Confirmed repeat measurement rate

Severe-Reading Confirmation

>80%

Automated response for high-risk events

Time-to-Response

<60 sec

First call attempt after critical trigger

Time-to-Clinician

<5 min

Relative reduction vs. baseline

ED Deflection

5–15%

Channel Strategy

Layered channels to reach every senior, regardless of tech literacy.

Channel	Adoption (65+)	Data Accuracy	Scalability	Best Fit
SMS Texting	Moderate–High	Medium	High	Default channel for one-number reporting
IVR (Keypad)	High (incl. landlines)	Low–Medium	High	Seniors who don't text
Voice Agent	Potentially High	Medium	Medium–High	Coaching + symptom checklist at scale
Connected BP Cuff	Variable	Low (transmission)	Medium	Higher-acuity monitoring

Get Started

Let's build your pilot together

Whether you're a Medicaid MCO looking to reduce ER utilization, a provider network exploring SMBP billing, or a health system seeking value-based partnerships — we'd love to talk.

For Payers & MCOs

We'll walk you through a 12-month pilot design with projected ROI based on your member data.

For Provider Networks

Learn how SMBP (99473/99474) and CCM codes can fund hypertension monitoring for your panel.

For Health Systems

Explore how Serene Pulse integrates with your existing care coordination and referral workflows.

Serene Pulse is currently seeking pilot partners in Virginia and the Mid-Atlantic region. State innovation grants (e.g., VIPC CCF up to $100K) can co-fund early deployments.