Deloitte: Digital tools can address maternal health inequities, but gaps in design remain

While digital tools have the potential to improve access to maternal care, a new Deloitte report shows that gaps in cultural competency and affordability still remain.

The report is based on a 2023 survey that reached more than 2,000 people who were pregnant in the last two years as well as a focus group with 10 hospital and health IT executives.

Though many respondents are using digital tools on their care journey, Black, mixed-race and Hispanic respondents were twice as likely as white respondents to say that digital tools for maternal health did not meet their personal needs or align with their cultural backgrounds.

More than 80% of respondents said people with lived experience should be involved in the inception, development and launch of digital tools for maternal health.

“Just creating the tool doesn’t absolve … the ecosystem from bringing those voices in,” Heather Nelson, managing director in Deloitte’s Life Sciences & Health Care practice and co-lead for the Health Equity practice, told Fierce Healthcare. “It’s essential that we have their voice in the mix.”

Patients use portals and mobile health apps most often among digital tools included in the report. Popular uses of digital tools overall are for scheduling appointments, communicating with clinical teams and for maternal health education. Other uses include to track reproductive cycles, for mental health support and to manage weight and nutrition. More than half of respondents believe digital tools can increase access to care, and 4 in 10 think they can help reduce out-of-pocket costs.

Making tools more culturally competent could mean providing information in different languages, showing conditions for different skin tones or accounting for cultural stigma related to topics like mental health, the report said. For example, InovCares, a maternal health app cited as a positive example in the report, connects women from diverse cultural backgrounds to culturally aligned providers virtually and in person. 

Digital tools can empower patients during visits with providers by supporting their concerns with concrete data, the report said.

In interviews with executives, Deloitte found that when patients can share data tracking physiological changes, providers feel better equipped to act on that information. The report cited a stillbirth prevention tool called Count the Kicks, which tracks fetal movements and aims to prevent potentially poor outcomes.

Data collected through digital tools can also be leveraged to hold providers accountable to higher-quality standards. Irth, a platform for Black mothers to publicly share their experiences with providers cited in the report, transforms qualitative narratives into quantitative data and works with hospitals, payers and providers to improve on inequities. 

At the same time, digital tools need to be more consumer-friendly and accessible going forward, according to respondents. Nearly half said reducing their cost is key, while 40% believe they should be covered by insurance. More than half desire a unified platform for maternal health information in the future. And many are overwhelmed by too many options on the market and want it to be easier to understand how to use such tools.

“Digital offerings should consider the information load and its impact on users’ ability to use tools effectively and make decisions for their health,” the report said.

Some Medicaid programs are beginning to tackle the issue of out-of-pocket costs, Nelson noted, leveraging digital or hybrid interactions to lower the cost of care. Digital tools can also streamline getting people into treatment sooner, Nelson added.

Trust in accuracy and a lack of bias also remain areas for improvement. Patient portals are most trusted among respondents, while wearables and mobile health apps could use upgrades in accuracy and both accuracy and bias, respectively. Companies can help overcome this gap by giving consumers more control over their data and being transparent about how they are being used. 

A few potential actions for stakeholders recommended in the report include: defining where and how equity, data, privacy and trust intersect with development and deployment; tailoring resources to specific needs; diversifying the data that inform resource development; incorporating patient voices into design; and collaborating with other sectors to address maternal health needs.

“We’ve got a complex system,” Nelson said, “we need all of the collaborators moving together.”

Black women face disproportionate disparities in maternal health outcomes in the U.S., with Black mothers three times more likely to die from pregnancy-related causes than white women.

“It’s a gut punch,” Nelson said. “I am very hopeful and very inspired by the reality that digital will and continues to play a role in transforming the system for the better.”