How digitally enabled care can improve postpartum outcomes

AMA News Wire

How digitally enabled care can improve postpartum outcomes

Jun 19, 2023

Obstetricians at Ochsner Health in Louisiana are turning to digitally enabled care to help improve health outcomes for mothers and their babies. And they are seeing results, according to ob-gyn Veronica Gillispie-Bell, MD, the head of women’s services for Ochsner Health Kenner.

Ochsner Health is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine. Ochsner also is a gold-level recognized organization of the AMA Joy in Medicine™ Health System Recognition Program.

Ochsner’s remote Connected Maternity Online Monitoring (MOM) program gives patients Bluetooth-enabled blood pressure cuffs and scales. These devices allow for more frequent monitoring of blood pressures, which can help prevent complications from high blood pressure, the leading causes of pregnancy-related deaths in Louisiana—as well as cardiovascular conditions, thrombotic embolism and hypertensive disorders of pregnancy.

Among patients with a hypertensive disorder of pregnancy, those in Connected MOM were twice as likely as those in traditional care to have blood pressure monitoring in the postpartum period.

Their 24/7 TeleStork program allows a nurse to provide a second set of eyes to monitor laboring mothers at hospitals across the health system by watching a livestream of maternal vitals and fetal tracings. It has reduced unexpected neonatal intensive-care unit admissions by 27% for term infants and reduced cesarean deliveries by 8%.

Child care and transportation are two of the biggest social determents of health that can create barriers for women accessing care, Dr. Gillispie-Bell said, and telehealth helps remove those barriers.

“When we think about the convenience, telehealth allows us to bring care to the patient instead of making the patient come to care,” Dr. Gillispie-Bell said during a webinar that is part of the AMA Future of Health Immersion Program, which helps physicians, practices and health systems optimize and sustain telehealth and digital care modalities at their organizations.

Supporting telehealth is an essential component of the AMA Recovery Plan for America’s Physicians.

Telehealth is critical to the future of health care, which is why the AMA continues to lead the charge to aggressively expand telehealth policy, research and resources to ensure physician practice sustainability and fair payment.

Not unlike other states, the March of Dimes considers one-third of Louisiana to be a maternity care desert. More than half of the state’s 64 parishes are considered rural and more than 60% of the state’s births are to patients covered by Medicaid.

Connecting these mothers with care in the postpartum period is crucial, Dr. Gillispie-Bell said, noting that data from the “Louisiana Pregnancy-Associated Mortality Review: 2017–2019 Report” showed that 61% of pregnancy-related deaths happened within the first six weeks after delivery and that 80% of those pregnancy-related deaths were preventable.

“When we think about our treatment landscape and we think about those barriers, we have to do more to make sure our patients are able to access care, especially once they have left the hospital,” she said.

To help ensure that patients everywhere and from all backgrounds can benefit from what telehealth has to offer, barriers to digital health care must be removed so that patients can access their physicians in this way, Dr. Gillispie-Bell said. Barriers include:

• Access, which includes devices as well as access to broadband internet.
• Affordability. Remote-monitoring devices can be pricey. Ochsner Health provides patients with monitoring devices.
• Digital health literacy. Some patients are more comfortable using devices than others and that comfort level needs to be addressed. Printing literature in multiple languages and in wording at a grade-school level are some examples of how Ochsner Health addresses the issue.

In addition to Dr. Gillispie-Bell, several other speakers also gave presentations during the webinar on other topics surrounding digitally enabled care for women.

Taylor Platt, MPH, of the American College of Obstetricians and Gynecologists, spoke about what the end of the COVID-19 public health emergency means for reproductive health, including what digital health services payers will continue to pay for and for how long.

Arij Faksh, DO, a maternal-fetal medicine physician at Scripps Clinic in San Diego, and ob-gyn Tolúwalàsé (Lasé) Ajayi, MD, director of clinical research at Scripps Research Translational Institute also presented. They discussed PowerMom, a research consortium that aims to address maternal health disparities with digital tools. In addition, Anish Sebastian, co-founder and CEO of Babyscripts, talked about the company’s pregnancy app.