Meta-analyses of RCTs of different telehealth inter- ventions have demonstrated greater SBP and DBP and a larger proportion of patients achieving BP controlS12.3.2-2 than those achieved with usual care without telehealth. The effect of various telehealth interventions on BP lowering was signifi- cantly greater than that of BP self-monitoring without transmission of BP data, which suggests a possible add- ed value of the teletransmission approach.S12.3.2-1,S12.3.2-3 Although mHealth interventions in general showed promise in reducing SBP in patients with hyperten- sion, results were inconsistent.S12.3.2-5 It is unclear which combination of telehealth intervention features is most effective, and telehealth has not been demonstrated to be effective as a standalone strategy for improving hypertension control. 12.4. Improving Quality of Care for Patients With Hypertension 12.4.1. Performance Measures Recommendation for Performance Measures References that support the recommendation are summarized in Online Data Supplement 65. COR LOE Recommendation IIa B-NR 1. Use of performance measures in combination with other quality improvement strategies at patient-, provider-, and system- based levels is reasonable to facilitate optimal hypertension control.S12.4.1-1 S12.4.1-3 Synopsis Efforts to improve suboptimal medical care include the use of performance measures, which are defined as standardized, vali- dated approaches to assess whether correct healthcare processes are being performed and that desired patient outcomes are being Performance measures are often combined with other quality improvement strategies, such as certification or financial incentives tied to higher-quality care.S12.4.1-5 Guidelines help define clinical care standards that can be used to develop per- formance measures.As guidelines evolve over time to incorporate new evidence, related performance measures may also evolve. 