The maternal health crisis in much of the United States remains unresolved. Our country reports the highest maternal mortality rate of any developed country in the world, and we are the only developed country to have seen an increase in maternal mortality in recent years. world population reviewIn addition, unhealthy mothers and families can lead to unhealthy babies and children, exacerbating the cycle of morbidity and mortality.
As a pediatrician, I have seen firsthand the emotional and physical toll that adverse pregnancy outcomes such as preterm birth can take on babies and their families. I have treated premature newborns whose families were unable to hold them for weeks after they were born. I have witnessed the burden of caring for a child who is permanently disabled due to premature birth or pregnancy complications. It is distressing to know that many of these outcomes can be prevented with better prenatal and maternal care.
Despite these dismal statistics and real-world experience, two positive changes are taking place in the maternal health of mothers and their newborns. Benefit expansion and technological advances are expected to lead to better maternal outcomes and healthier pediatric populations.
This article provides a brief overview of new legislative changes that have had a clear impact on maternal health. Additionally, two specific healthcare data use cases are explored as an effective way to identify, treat, and connect at-risk mothers with maternal healthcare providers to promote better maternal health outcomes and healthier children.
Postpartum Medicaid and CHIP Coverage Expanded
April 1, CMS announced Expanded postpartum Medicaid and CHIP coverage from 60 days to 12 months under the American Rescue Program (ARP). CMS further applauds Four states passed the extension last month.While expansions could be implemented in every state, this executive move bodes well for improving maternal health in the U.S.
Expanding coverage is an important step in addressing the maternal health crisis.With 42% of births in the U.S. covered by Medicaid, more than 50% of maternal deaths occur within 12 months back After birth, large numbers of mothers and babies now have more stable coverage and care when they need it most.
Increasing the duration of postnatal insurance is a critical step in the right direction, but these problems will be exacerbated as patients flood into a fragmented healthcare system. Technological advances are playing a key role in addressing some of the long-standing issues that contribute to the maternal health crisis.
Data closes maternal health gaps
Increasing access to perinatal care, ensuring early detection of pregnancy and complications, addressing health disparities, and eliminating maternal care deserts are key strategies for states and healthcare organizations (HCOs) toward improving maternal health. Participating in structured state or national perinatal quality improvement (PQI) collaborations is another valuable approach. Underpinning all these strategies is the need for data.
Health data is fragmented, and members of obstetric and pediatric care teams often don’t have access to patient data when it’s needed most. For example, a pregnant patient with headaches may visit the hospital, but her elevated blood pressure readings and a diagnosis of preeclampsia may not reach the primary obstetrician quickly enough, if at all.
These improvements cannot be performed without high-quality, timely, and actionable data that enables members of the patient care team to quickly understand who needs help, where to allocate resources, and how to target efforts for maximum impact. Here are two specific ways technology can help.
Improve prenatal data interoperability
Inadequate prenatal care, including later visits to the doctor and/or fewer prenatal visits, was associated with a higher risk of preterm and low birth weight infants, premature rupture of membranes, non-breastfeeding, and rapid or acute labor. Ensuring adequate and timely prenatal care can help reduce the risk of preterm birth, pregnancy-related complications and death, and lead to better health outcomes for mothers and babies.
Ensuring that patients receive adequate prenatal care requires the ability to collect, aggregate and share relevant data points. This includes pregnancy status, the number and timing of antenatal visits, and insurance coverage for all births. Once an obstetric patient is identified, real-time data sharing and alerting technologies can be used to inform clinicians across the care team about new and high-risk pregnancies, enabling these clinicians to triage and intervene in real time.
Insurance data is valuable for identifying patients who do not have adequate insurance coverage and may be eligible for Medicaid to ensure access to prenatal services. Data from clinics, doctors’ offices, and hospitals tells a story for each setting and, when aggregated, paints a complete picture of maternal health. This allows the care team to quickly reach the highest risk patients and provide any necessary support.
It is also important for obstetrics and gynecology providers to be aware of changes in patients’ clinical status that may increase their risk of adverse outcomes. These risk factors include a new diagnosis or laboratory evidence of conditions such as preeclampsia or gestational diabetes. In addition, behavioral health status and socioeconomic or environmental factors are important risk factors that need to be shared with appropriate members of the care team. For example, poor transportation is one reason why many mothers in urban and rural areas do not have access to antenatal care.
Interoperable data systems capture these risk factors in real-time and ensure that the right resources are accessed exactly when needed. The care team must be aware of the risk factors that significantly affect pregnancy and outcome. The postpartum period is equally critical to the health of the mother, as demonstrated by the expansion of postpartum insurance coverage mentioned above.
Access postpartum data over time
according to Commonwealth Fund 2020 Report In terms of maternal mortality, 52% of pregnancy-related deaths in the United States occur postpartum. In addition to expanding Medicaid coverage, both clinical care teams and public health professionals need high-quality, timely data in order to provide patients with the best possible care.
Common gaps include team members not knowing when a patient will give birth, which can lead to delays in important services. Additionally, they may be unaware of emergency room visits or complications that require more intensive intervention, such as postpartum depression or postpartum hypertension. Access to these types of data is needed during the postpartum period to monitor populations at highest risk for adverse postpartum outcomes.
Electronic health records and other systems should ensure that postpartum data can be accessed and shared by all members of the care team. Everyone must know about mothers at high risk so that the right services can be provided in a timely manner.
in conclusion
Expanded maternal health care coverage, health information technology, and timely access to pregnancy data are needed to coordinate care and address maternal health in the U.S. Now is the time to bring patients and providers together through digital infrastructure and break down maternal health information silos time to negatively impact maternal health.
Working together, we can improve maternal health outcomes by identifying patients and their risk factors in real time and ensuring that appropriate members of the care team intervene early and often throughout pregnancy and beyond.
