Mobile prenatal care visits can be just as effective as in-person provider visits, according to a recent study published in JMIR mHealth and uHealth.
Using a mobile app, researchers at the George Washington University School of Medicine and Health Sciences set out to see whether technology could take some of the cost and burden out of prenatal visits.
Previous studies have shown the number of in-person prenatal care visits can be reduced for low-risk patients by using a virtual care model, essentially saving patients and providers money. However, many of these studies also show a reduction in patient satisfaction equated with fewer visits.
According to a recommendation by the American College of Obstetricians and Gynecologists, almost one-third of low-risk women receive more visits than recommended, but the providers say visits are hard to cut back on due to decreased patient satisfaction, the need for weight and blood pressure monitoring as well as the importance of providing educational information around pregnancy health.
This most recent study tested out a prenatal app with the hopes of reducing in-person visits to a provider while maintaining patient and provider satisfaction.
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The trial used an experimental group that received a mobile app with integrated Wi-Fi for blood pressure and weight monitoring along with a control group that received traditional prenatal care. The technology used for the study, created by a company called Babyscripts, was supplied by a mobile health technology firm, 1EQ.
Babyscripts was designed with two major goals: to deliver educational content via mobile and to remotely monitor blood pressure and weight. To collect results, patients were given satisfaction surveys to complete at several gestational intervals.
“The goal of the Babyscripts app is to make necessary prenatal care available at any time, in any place, for anyone, regardless of socioeconomic status, through the power of connected technology,” Juan Pablo Segura, founder of Babyscripts, told FierceHealthcare. “As our study showed, we have an incredible opportunity to digitize large chunks of prenatal care so that patients don't always have to travel to a clinic to check in with their doctor. Think of how many patients struggle to take time off of work to see the doctor. Babyscripts is a tool focused on democratizing prenatal care to anyone who has a smartphone.”
According to collected data, patient satisfaction over several intervals showed no difference between the experimental and control groups. Therefore, the authors concluded pregnant women represent a promising target for digital health apps.
Segura calls prenatal care in the U.S. a “monolithic, a one-size-fits-all approach to detecting problems and classifying risk.” He believes that the current structure, where women are seen at least 14 times during pregnancy, is not tailored to a patient's specific risk profile and encourages unnecessary visits and costs.
But technology like Babyscripts could help to tailor prenatal care to the risk of the patient.
“We also believe that by capturing more data on a pregnant patient, we can better identify risk in real time so that complications are caught earlier than normal,” Segura added. As an example, he noted complications from preeclampsia alone cost the healthcare system more than $2 billion annually.
Several elements did emerge from the study as critical to the future of a successful prenatal care app. First, an assessment of high-risk versus normal-risk pregnancy is necessary. Second, the patient must give accurate data to the provider so complications are caught immediately. Third, educational components must be timed with the gestational week. And four, educational information should be individualized toward the patient.
Of course, the wider implementation of Babyscripts is similar to any new technology platform: It requires education and buy-in from providers. Technology such as this has the power to improve practice workflows by reducing visits while giving care teams access to more patient data points. But Segura says the benefits cannot be fully realized until the whole provider practice has adopted the program. Plus, there is the hurdle of wanting immediate quantifying results.
“While ROI from this product is felt immediately (less visits, more access), outcomes related benefits—such as a reduction in preterm births, decrease in readmissions, lower mortality rates, etc.—take longer to experience and quantify, presenting its own challenges to adoption for those who want to reference an immediate effect on outcomes,” he said.
In the future, Serga hopes the industry will embrace healthcare technology and not fear it.
“This study is a reminder that we need to shift the view of technology, not as a replacement, but as an enhancement to care,” he said. Further, it confirms that technology has the power to capture significantly more data points from patients that providers can use to make more informed treatment decisions.