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PROTOTYPE — synthetic data only. Not medical advice.
North State Prevention

One program · three device tiers

Meet patients where their tech is.

North State Prevention accepts readings from Bluetooth, Wi-Fi, and cellular BP cuffs on the same signed ingestion endpoint. The triage engine, patient-facing nudges, and clinician queue are identical across tiers — only the transport and the cost differ.

How the loop works Pilot pitch

Tier 1 · Bluetooth

Cheapest, for patients comfortable with a smartphone.

Patient fit
Has a smartphone and is willing to open the app after each reading.
Device
FDA 510(k)-cleared BLE cuff — A&D UA-651BLE or Omron Silver BP5250 as reference budget options. Evolv / Complete run higher.
Upfront
≈ $50–75 (≈ $50 at 500+ units)
Monthly
$0 device / patient pays subscription

Setup

  1. Patient installs the app and pairs the cuff once (BLE GATT 0x1810).
  2. Cuff talks to the phone; the phone POSTs the signed reading to the same endpoint.

Why choose it

  • Lowest hardware cost — best fit for uninsured, self-pay pilot.
  • Patient owns the device; no shipping logistics per enrollment.
  • Works with any vendor implementing the standard BLE BP profile.

Tradeoffs

  • Requires a modern smartphone and some tech comfort.
  • Readings only sync when the app is opened / in range.
  • $50 is a realistic pilot-scale floor for a 510(k)-cleared BLE cuff sourced through a medical distributor; retail single-unit pricing runs $60–75.
Medicare RPM: Eligible for CPT 99454 if the app confirms automatic transmission (no manual entry).

Tier 2 · Wi-Fi

No phone needed at reading time; cuff uploads itself.

Patient fit
Has home Wi-Fi and can complete a one-time setup (or a family member can).
Device
Wi-Fi cuff (Omron 10 Series BP7450 ~$75–85 bulk, iHealth Clear ~$90 bulk).
Upfront
≈ $80–100
Monthly
$0 device / patient pays subscription

Setup

  1. One-time Wi-Fi provisioning during enrollment (phone or clinic tablet).
  2. Cuff pushes each reading to the vendor cloud → webhook into our endpoint.

Why choose it

  • Reading captured whether or not the phone is around.
  • Good middle ground for older patients who have Wi-Fi but rarely open apps.

Tradeoffs

  • Setup fails without stable Wi-Fi (rural / shared housing).
  • Requires vendor cloud → our webhook — one extra integration to maintain.
Medicare RPM: Eligible for CPT 99454 (automatic transmission built in).

Tier 3 · Cellular

Zero setup for the patient. Highest cost. Best for Medicare RPM.

Patient fit
No smartphone, no Wi-Fi, or wants a device that Just Works — often elderly / Medicare.
Device
Cellular hub (Omron VitalSight) — partnership-only, not sold retail.
Upfront
≈ $120–150 hardware
Monthly
≈ $10–15 LTE (often bundled $25–40/mo/patient via RPM vendor)

Setup

  1. Ship pre-provisioned hub; patient plugs it in and takes readings.
  2. Hub POSTs directly to our endpoint over LTE — no phone, no Wi-Fi.

Why choose it

  • Truly zero patient tech burden — highest adherence in older cohorts.
  • Institutionally proven (Northwestern, Mount Sinai VitalSight deployments).
  • Cleanest Medicare RPM billing story: fully automatic transmission from day 1.

Tradeoffs

  • Highest per-patient cost — reserve for patients where Tiers 1–2 aren't viable.
  • Requires vendor partnership (Omron VitalSight application in progress).
  • Distribution requires an active vendor partnership; pricing negotiated per contract.
Medicare RPM: Purpose-built for CPT 99453/99454/99457 — the reference tier for reimbursement.

Why the app doesn't care which tier

Every reading — BLE from a paired phone, Wi-Fi from a home cuff, or LTE from a cellular hub — is signed and POSTed to /api/public/ingest/reading. The payload carries a deviceType tag for reporting, but the UC Way triage engine, KDIGO carve-outs, motivational-interviewing nudges, and clinician alert queue run the same code path for all three. That means we can enroll a Medicare patient on cellular and their uninsured neighbor on a $40 BLE cuff into the exact same program — one triage engine, one clinician queue, two very different cost profiles.

Recommended vendor family: Omron — they ship devices across all three tiers so patients can move between tiers without switching brands or re-teaching cuff placement.

Pricing notes. Numbers are pilot-scale estimates (50–500 units) for FDA 510(k)-cleared cuffs sourced through a medical distributor (McKesson, Henry Schein) or a direct manufacturer contract. Retail single-unit pricing is higher; $50 per BLE cuff assumes a distributor contract at 500+ units. Cellular pricing is illustrative — VitalSight is only available through a signed Omron healthcare partnership.