In the past few years, we have seen an increase in the use of technology to improve the outcomes of women and the birthing journey. Although many women still have visits to check on their pregnancy, delivery or post-partum check-ups, technology can increase the reach of health care.
Digital solutions, including remote patient monitoring, mobile health apps, and telehealth visits can facilitate continuous communication between expectant mothers and newborns and their care teams. They can also provide comfort and security, which is very important in this season of life.
As hospitals and health systems increase the use of technology, it is important to remember that not all patients have access to digital solutions. There are many barriers to access – including a lack of broadband or internet at a speed sufficient to support these solutions. According to Federal Communications Commission data, 21 million Americans do not have access to broadband Internet; 42 million cannot afford to buy. In addition, many people still do not have cell phones. The Pew Research Center reports that 14% of rural residents own a cell phone but not a cell phone.
Even with access to technology, digital literacy – the ability to use, process and understand technology – can be a barrier to access. For example, people may face language or cultural barriers that are necessary to use digital technologies.
At the Becker’s Healthcare conference, I had the opportunity to discuss digital solutions and the work that needs to be done to create a digital health partnership, with two health leaders – Alisahah Jackson, MD, CommonSpirit Health’s vice president of public health policy and strategy and Christina . Yarrington, MD, director of labor and delivery and the division director for maternal fetal medicine at Boston Medical Center.
In this discussion, everyone shared how their hospitals are using digital technology to improve fertility. They also shared how they select, implement and evaluate these solutions to ensure that all their patients can access them.
Here are some ways that Jackson and Yarrington suggest we can improve the effectiveness of digital services and ensure that all women and their families have access to these digital solutions:
- Put on a health-related lens and focus on purpose. Promoting equity isn’t something you can just check on your paycheck. It is a commitment that healthcare organizations and their technical liaisons must incorporate into all of their efforts. Before implementing a digital strategy, initial discussions with digital solutions vendors should be viewed through a health lens. “We examine solutions to the availability and volume of health education, and whether their data collection capabilities include the ability to disaggregate data by race, ethnicity, language, and gender,” Jackson shared.
- Use simple and inexpensive methods, depending on your region of deployment. One way to improve access is to provide technology directly to patients. For example, Boston Medical Center partnered with Rimidi to provide blood pressure cuffs with a QR code to postpartum women to monitor their blood pressure remotely, every day for six weeks. Instructions for using the cuff and submitting blood pressure readings to the website are provided in three languages. However, Yarrington said, “We can provide patients with the device but we also have to anticipate any barriers to using it. Cell phone users may not have a data plan to support video conferencing or struggle to connect to Wi-Fi all the time to communicate with their caregivers. ” To address this problem, BMC chose Rimidi because it operates a local network, and its website is used by high-risk OB nurses to provide screening services and other support. The BMC program is known to be very low in the number of high-risk postpartum women with hypertension.
In addition, having a mobile phone does not mean you can use the platform. Text messaging, a common service available on all smartphones now, can be a cost-effective, two-way, multilingual way to reach and connect with patients. CommonSpirit uses Get Well’s Docent Digital navigation solution because it provides a way to connect women and their families to a “docent” who provides support to patients throughout pregnancy and after pregnancy.
- Integrate patient diversity to improve digital technology and individualized care. Hospitals can interact with community organizations, women in their community, and the diverse voices of patients who are not well known, communities and providers to see if these digital solutions are accessible and understandable by all types of patients and communities. For example, health organizations and professional partners can connect with women with poor health literacy to understand their preferences, and tailor services to meet their needs and build trust.
- Track patient engagement with digital tools to measure effectiveness and monitor performance. Measuring patient response to a digital strategy is an important part of ensuring that they can gain and grow a larger segment. In 2021, Boston Medical Center analyzed data on the first 1,000 people who enrolled in its program and found 98.7% provided at least one blood test, and received more than 17 unique tests from enrolled patients each day. At CommonSpirit, rates related to its various services and the Docent Health platform are at 65% in all ethnic groups, and the highest at 73% in Hispanic areas. Jackson attributed this widespread use to its ability to provide care in a language and language that patients prefer and speak.
As hospitals and health systems explore the role of technology, it will be important to meet patients and people not only where they are, but where they want to be. This will help ensure that everyone has equal access to and use of digital solutions. To learn more about other digital solutions for perinatal care, listen to the AHA’s Seven in Seven: Digital Solutions for Perinatal Care podcast series.
Are you selling digital solutions to improve the health of pregnant women? Email Aisha Syeda at email@example.com and share your journey.
Priya Bathija, JD, MHSA, serves as the AHA’s vice president of primary care.