AMA News Wire
Digital health program cuts pre-term births by 20%
May 2, 2024
Not all telehealth programs began during the COVID-19 pandemic. Ochsner Health started connecting pregnant patients with its digital medicine obstetric program in 2016 and has since achieved success across six key performance metrics including improved clinical outcomes, access to care and health equity.
Ochsner Health’s Connected MOM (Maternity Online Monitoring) initiative uses digital health tools to offer expectant mothers a convenient way to safely manage their pregnancy in collaboration with their physicians at some 20 clinical sites in Louisiana and Mississippi.
In 2022, Ochsner Health enrolled about 205 pregnant patients per month in the program, with nearly 1,600 enrolled at any given time that year and more than 2,250 patients in total for the year, according to an AMA Future of Health case study (PDF).
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.
Patients are given a blood-pressure cuff to enable them to submit BP readings remotely via their personal smartphone.
This enables ob-gyns and patients to track key health readings and receive alerts when a reading is outside normal thresholds. Once alerted, physicians work with patients on a care plan.
Ochsner Health's program caught the attention of Sen. Bill Cassidy, MD (R-La.), who then used it as the foundation of his Connected MOM Act, a bipartisan bill supported by the AMA (PDF). The bill would provide state Medicaid programs with remote physiologic monitoring devices and related services through Medicaid.
The Connect MOM program is especially helpful in detecting the hypertensive disorders of pregnancy, like preeclampsia, which is responsible for up to 7% of pregnancy-related deaths in the U.S.
Measures indicate success
The case study notes that the program has achieved significant success across these six dimensions.
Clinical outcomes. Connected MOM participants overall had 20% lower odds of pre-term. The program also helped identify patients with “masked hypertension,” which includes those who had hypertension at home but a normal BP measurement in the clinic and are nonetheless at an increased risk for adverse outcomes. Those patients were given early intervention and closer monitoring.
The standard of care in physician well-being recognition
Institutions in this article have been honored by the Joy in Medicine™ Health System Recognition Program.
Access to care. Ochsner Health’s team of more than 120 ob-gyns and certified nurse midwives delivered more than 10,860 babies—of which, about 20% were enrolled in Connected MOM. The option of substituting some in-office visits with virtual visits also was a benefit to patients with transportation challenges, and was helpful to those who otherwise would have had to take time off from work and secure child care to see their physician.
Patient, family and caregiver experience. Ochsner Health data indicates that 10.7% of patients in Connected MOM are re-enrollees, “highlighting a high level of satisfaction with the program,” says the case study.
Clinician experience. Because it is so easy to use the program’s digital tools, staff can better manage their time and offer support to more new patients. For every 1,000 patients enrolled in Connected MOM, the capacity of an ob-gyn’s clinic increases by the equivalent of 0.6 of full-time employee.
Financial operational experience. Connected MOM is offered at no additional cost to patients.
Health equity. Connected MOM supports the recruitment of a diverse demographic of patients, with more than 60% of enrollees being between 26–35 from various racial backgrounds, including 29% Black and 5% Asian, with about 30% of enrollees covered by in-state Medicaid programs.
Grant funding has helped pay for much of the program, so the passage of Dr. Cassidy’s bill would go a long way toward making the program sustainable.
“We're asking for CMS [the Centers for Medicare & Medicaid Services] to make sure that not just the moms who go to Ochsner, but all moms across the United States are able to benefit from the Bluetooth-enabled blood-pressure devices and remote patient-monitoring devices such as those used in Connected MOM,” Veronica Gillispie-Bell, MD, MAS, head of women's services at Ochsner Medical Center-Kenner, said in a recent episode of “AMA Update.”
“If we're really looking to bring resources to those individuals, to those patients who need it the most, we have to have federal support,” Dr. Gillispie-Bell added.
Support for patients and physicians
The case study also highlights how Ochsner Health leverages the foundational pillars for “addressing the digital health disconnect” described in the AMA-Manatt Health report Closing the Digital Health Disconnect: A Blueprint for Optimizing Digitally Enabled Care (PDF).
The blueprint's foundational pillars to achieve digitally enabled care are:
- Build for patients, physicians and clinicians.
- Design with an equity lens.
- Recenter care around the patient-physician relationship.
- Improve and adopt payment models that incentivize high-value care.
- Create technologies and policies that reduce fragmentation.
- Scale evidence-based models quickly.
In describing how the program is built for patients, physicians and other health professionals, the case study notes that patients are sent reminders to take their BP reading. Patients also receive a weekly planner and checklist for tracking their vital signs.
“The program has been thoughtfully designed to support both patient and clinician needs,” the case study says.
Regarding the pillar on creating technology that reduces fragmentation, the case study notes that sharing data via the patient’s smartphone app means that patients don’t need to copy or transcribe the data to message their physician. “Connected MOM allows for a centralized location for both the care team and the patient to access information, track progress, [and] identify trends,” the case study says.
Read additional case studies that highlight successful collaborations between health systems or physician practices and digital health companies that are providing digitally enabled care and driving the future of health.
