Remote patient monitoring can help address the maternal mortality crisis

By | August 15, 2020

In 2017, about 810 women around the world died every day from pregnancy-related causes. The United States’ maternal mortality rate is an abysmal one, particularly for Black women and Native women – whose risk is three to four times higher than that of white women.

“I am so done with the numbers,” said Fran Ayalasomayajula, head of the population health portfolio for worldwide healthcare, at HP. “I’m glad that now, after ten years, we have new data. Meanwhile, today somewhere 900 women are dying. Giving birth and dying. And we’re still talking about the numbers. I am so done!”

Ayalasomayajula, a public health professional with a background in epidemiology, is the president and founder of Reach, whose mission is to improve health experiences for both patients and providers. 

In 2018, the Reach team selected maternal morbidity and mortality as a focus area. Now, in the final year of its three-year innovation life cycle, the team is moving to collaborate with stakeholders on developing demonstrations and solutions to address the maternal mortality pandemic.

“Think about the impact when a mother dies,” she said. “It’s not just her life. It’s the life of a child. It’s the economy of this country.”

“I see this as a public health emergency,” she continued.

One major tool in confronting that emergency, she said: blood pressure monitors. Hypertension poses a variety of risks to pregnant people, some of them lasting or even deadly. Industry groups have advised the advantages of blood pressure monitoring of symptomatic patients, and studies have shown that remote patient monitoring via text message after childbirth can be a successful method for postpartum hypertension surveillance. 

But, Ayalasomayajula points out, not all patients show signs of hypertension. Instead, she said, “The whole idea is that I want for every woman in her third trimester to have access to a blood pressure monitor.”

“I see this as a public health emergency.”

Fran Ayalasomayajula, Reach

Such a plan would need buy-in from a number of stakeholders. Software developers could create apps to track the information and sync with connected devices, for example. Pharmacies could offer rebates or coupons on equipment. And payers could act to reimburse patients for the purchase, which many do not.

Clinicians, too, could introduce the idea as a feasible way for pregnant patients to keep track of potentially troubling symptoms.

“Women are being overlooked,” she said. During pregnancy, “the emphasis becomes increasingly about the fetus … and less of an emphasis on the changes coming over the woman. And then when the baby is born, the attention shifts completely to the child.” 

Because of this, she said, both providers and patients may be missing telltale signs of trouble.

“Using digital tools in that way – putting the emphasis on the mother and adding attention to the mother – we can address these things,” she said. “There are multiple levels of insight” that can be gained.

As with other healthcare specialties, Ayalasomayajula notes that the COVID-19 pandemic has had a staggering effect on OB/GYN care.

“A lot of women during the pandemic are not getting the prenatal care they need,” she said, pointing to the fear of transmission during in-person visits. “And who could blame them?”

Although telehealth is certainly helpful, she notes that, again, without blood pressure monitors (which many pregnancy-age patients might not have), clinicians are missing key data points.

Over the next six months, Ayalasomayajula hopes to gather support for a six-month demonstration pilot project in collaboration with Wonder Healthcare Solutions, a software company aimed at reducing maternal mortality. 

She also wants to make inroads with device manufacturers and other stakeholders in the industry, along with creating materials aimed at patients and clinicians.

“When I created the national campaign, people said it was ambitious, but I said, ‘Honestly, it’s not,”’ she said. “It’s a matter of us putting our egos and our politics out of the way.”

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.

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