{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T17:44:16Z","timestamp":1780595056152,"version":"3.54.1"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2017,10,4]],"date-time":"2017-10-04T00:00:00Z","timestamp":1507075200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Hypertension affects one in five adults worldwide. Healthcare processes require interdisciplinary cooperation and coordination between medical teams, clinical processes, and patients. The lack of patients\u2019 empowerment and adherence to treatment makes necessary to integrate patients, data collecting devices and clinical processes. For this reason, in this paper we propose a model based on Business Process Management paradigm, together with a group of technologies, techniques and IT principles which increase the benefits of the paradigm. To achieve the proposed model, the clinical process of the hypertension is analyzed with the objective of detecting weaknesses and improving the process. Once the process is analyzed, an architecture that joins health devices and environmental sensors, together with an information system, has been developed. To test the architecture, a web system connected with health monitors and environment sensors, and with a mobile app have been implemented.<\/jats:p>","DOI":"10.3390\/s17102273","type":"journal-article","created":{"date-parts":[[2017,10,4]],"date-time":"2017-10-04T13:53:55Z","timestamp":1507125235000},"page":"2273","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Empowerment of Patients with Hypertension through BPM, IoT and Remote Sensing"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8919-8863","authenticated-orcid":false,"given":"Daniel","family":"Ruiz-Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Department of Computer Technology, University of Alicante, 03690 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6560-2067","authenticated-orcid":false,"given":"Diego","family":"Marcos-Jorquera","sequence":"additional","affiliation":[{"name":"Department of Computer Technology, University of Alicante, 03690 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7711-5357","authenticated-orcid":false,"given":"Virgilio","family":"Gilart-Iglesias","sequence":"additional","affiliation":[{"name":"Department of Computer Technology, University of Alicante, 03690 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5187-5689","authenticated-orcid":false,"given":"V\u00edctor","family":"Vives-Boix","sequence":"additional","affiliation":[{"name":"Department of Computer Technology, University of Alicante, 03690 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Ram\u00edrez-Navarro","sequence":"additional","affiliation":[{"name":"Department of Computer Technology, University of Alicante, 03690 Alicante, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,10,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.1016\/S0140-6736(02)11911-8","article-title":"Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies","volume":"360","author":"Lewington","year":"2002","journal-title":"Lancet"},{"key":"ref_2","unstructured":"WHO (2015). Q&As on Hypertension, WHO."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1097\/HJH.0b013e32834ab497","article-title":"Prevalence and incidence of hypertension in a population cohort of people aged 65 years or older in Spain","volume":"29","author":"Banegas","year":"2011","journal-title":"J. Hypertens."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"922","DOI":"10.4103\/2141-9248.144914","article-title":"Determinants of Patient\u2019s Adherence to Hypertension Medications: Application of Health Belief Model Among Rural Patients","volume":"4","author":"Kamran","year":"2014","journal-title":"Ann. Med. Health Sci. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1093\/fampra\/cmh202","article-title":"Why hypertensive patients do not comply with the treatment: results from a qualitative study","volume":"21","author":"Llor","year":"2004","journal-title":"Fam. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1046\/j.1365-2710.2001.00363.x","article-title":"Patient adherence to treatment: Three decades of research. A comprehensive review","volume":"26","author":"Vermeire","year":"2001","journal-title":"J. Clin. Pharm. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"McAllister, M., Dunn, G., Payne, K., Davies, L., and Todd, C. (2012). Patient empowerment: The need to consider it as a measurable patient-reported outcome for chronic conditions. BMC Health Serv. Res., 12.","DOI":"10.1186\/1472-6963-12-157"},{"key":"ref_8","unstructured":"World Health Organization (2012). Health 2020: A European policy framework supporting action across government and society for health and well-being. Proceedings of Regional Committee for Europe, WHO."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1089\/tmj.2010.0015","article-title":"Impact of Blood Pressure Telemonitoring on Hypertension Outcomes: A Literature Review","volume":"16","author":"AbuDagga","year":"2010","journal-title":"Telemed. E-Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11906-015-0535-3","article-title":"The Role of Telemedicine in Hypertension Management: Focus on Blood Pressure Telemonitoring","volume":"17","author":"Omboni","year":"2015","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.chb.2016.03.065","article-title":"Health empowerment through activity trackers: An empirical smart wristband study","volume":"62","author":"Nelson","year":"2016","journal-title":"Comput. Hum. Behav."},{"key":"ref_12","unstructured":"Harmon, P. (2014). Business Process Change: A Business Process Management Guide for Managers and Process Professionals, Elsevier Inc.. [3rd ed.]."},{"key":"ref_13","unstructured":"Smith, H., and Fingar, P. (2003). Business Process Management: The Third Wave, Meghan-Kiffer Press."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1007\/s00423-012-0914-z","article-title":"New methods for clinical pathways\u2014Business Process Modeling Notation (BPMN) and Tangible Business Process Modeling (t.BPM)","volume":"397","author":"Scheuerlein","year":"2012","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"32","DOI":"10.5923\/j.se.20110102.04","article-title":"Supporting Continuous Improvement in Care Management with BPM","volume":"1","author":"Bochicchio","year":"2012","journal-title":"Int. J. Softw. Eng."},{"key":"ref_16","unstructured":"(2017, May 17). Hypertension in Adults: Diagnosis and Management. Available online: https:\/\/www.nice.org.uk\/guidance\/cg127\/chapter\/1-guidance."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s11883-017-0649-y","article-title":"Mobile Health (mHealth) Technology for the Management of Hypertension and Hyperlipidemia: Slow Start but Loads of Potential","volume":"19","author":"Rehman","year":"2017","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1177\/193229681300700307","article-title":"Mobilizing your medications: An automated medication reminder application for mobile phones and hypertension medication adherence in a high-risk urban population","volume":"7","author":"Patel","year":"2013","journal-title":"J. Diabetes Sci. Technol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1016\/j.amjhyper.2007.03.020","article-title":"Mobile Phone-Based Remote Patient Monitoring System for Management of Hypertension in Diabetic Patients","volume":"20","author":"Logan","year":"2007","journal-title":"Am. J. Hypertens."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.datak.2006.04.007","article-title":"IT support for healthcare processes\u2014Premises, challenges, perspectives","volume":"61","author":"Lenz","year":"2007","journal-title":"Data Knowl. Eng."},{"key":"ref_21","first-page":"2","article-title":"What BPM technology can do for healthcare process support","volume":"Volume 6747","author":"Reichert","year":"2011","journal-title":"Lecture Notes in Computer Science (Including Subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)"},{"key":"ref_22","first-page":"3","article-title":"The internet of things in healthcare: An overview","volume":"1","author":"Yin","year":"2016","journal-title":"J. Ind. Inf. Integr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.ijnurstu.2017.01.009","article-title":"The Internet of Things for basic nursing care\u2014A scoping review","volume":"69","author":"Mieronkoski","year":"2017","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_24","unstructured":"Kim, S., and Kim, S. (2017). User preference for an IoT healthcare application for lifestyle disease management. Telecommun. Policy, 1\u201311."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.cmpb.2016.03.024","article-title":"The monitoring and managing application of cloud computing based on Internet of Things","volume":"130","author":"Luo","year":"2016","journal-title":"Comput. Methods Progr. Biomed."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.procs.2016.04.103","article-title":"Patient Monitoring System Based on Internet of Things","volume":"83","author":"Oviedo","year":"2016","journal-title":"Procedia Comput. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1157\/13100277","article-title":"The Influence of Pressure and Temperature on the Behavior of the Human Aorta and Carotid Arteries","volume":"60","author":"Atienza","year":"2007","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_28","first-page":"1","article-title":"2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults","volume":"1097","author":"James","year":"2013","journal-title":"JAMA"},{"key":"ref_29","unstructured":"Erl, T., Merson, P., and Stoffers, R. (2016). Service-Oriented Architecture: Analysis and Design for Services and Microservices, Prentice Hall."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1093\/jamia\/ocv189","article-title":"SMART on FHIR: A standards-based, interoperable apps platform for electronic health records","volume":"23","author":"Mandel","year":"2016","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"ref_31","unstructured":"Hohpe, G., and Woolf, B. (2004). Enterprise Integration Patterns: Designing, Building, and Deploying Messaging Solutions, Addison-Wesley."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/17\/10\/2273\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:46:36Z","timestamp":1760208396000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/17\/10\/2273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,4]]},"references-count":31,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2017,10]]}},"alternative-id":["s17102273"],"URL":"https:\/\/doi.org\/10.3390\/s17102273","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,4]]}}}