Bonnie Tung, Senior Product Manager at Babyscripts was in attendance, along with Dr. Lauren Demosthenes, Senior Medical Director. Read on for their thoughts and key takeaways.
Digital health is a proven tool to combat racial disparity.
Babyscripts added an important case for the role of digital health and RPM in addressing these concerns. Dr. Lauren Demosthenes presented a case study highlighting the role of Babyscripts’ remote monitoring in meeting AIM goals and reducing racial inequities in the postpartum period, with the following results:
At an in-office appointment, Black patients logged blood pressure at rates 30 points lower than White patients.
With at-home monitoring through Babyscripts blood pressure monitoring, ascertainment jumped to 95% for both populations, eliminating the gap perceived in-office.
Without having to worry about childcare, time off work, transportation, or an unfriendly healthcare system, both groups had significantly higher rates of ascertainment and reported higher rates of satisfaction and ease of use.
The system benefits from community-based models, but infrastructure is lacking.
A recurring theme of the event was the importance of community, and the need to support traditional care models with non-physician alternatives such as midwifery. While these conversations sparked important dialogue, there were significant gaps when considering a practical path forward, for example the infrastructure barriers that have prevented midwifery from scaling. Much was made of the importance of doula care, but no solutions proffered for issues of insufficient reimbursement or shortage of skilled doulas. On the other hand, no mention was made of group prenatal care, a community-based alternative that has proven success and is supported by clinical evidence. While community-based care models have industry support, the conversations revealed that many are still lacking clinical evidence and workable business models.
Reassessing traditional models of care extends to education and legacy care protocols.
What these conversations did confirm, however, is that maternity care is moving in a direction that will embrace more options for care delivery. The demographics of pregnancy are shifting — soon, women of reproductive age will only have known life in the digital age, and that will inform how they consume information, and from whom. Education for rising physicians needs to match that shift — and to take into account an emerging demand for hybrid care that will involve working with diverse care providers.
One of the traditional methods that came under scrutiny was the habit of using “checklists” to measure a patient's compliance to a care plan. Some voiced concerns that a checklist gives the perception of comprehensive care, but may exclude critical touch points or empathetic listening. At the same time, it’s an important failsafe for a provider who, in addition to the need to understand the lived experience of their patient, must ensure that important clinical information is communicated during a short visit period and handle administrative tasks as well. The utility of checklists cannot be dismissed, but there is general agreement that the manner in which they are incorporated into a care routine should be reassessed.
Where we go from here is becoming clearer, but the method is less so.
Scalability was a major topic at the conference. The pregnancy journey requires high-touch services (beyond just monitoring clinical data), but services are historically hard to scale due to the difficulty of providing a consistent and repeatable experience. Unit economics and scalability in turn present an issue to venture companies that may have an eye towards exit opportunities such as acquisition or IPO, with the result that certain startups (primarily those with devices / IP) are more likely to accelerate. More service-oriented models are essential to healthcare, but while a few have attracted serious funding, the majority have struggled.
The ever-present buzz around “value-based care” was not absent, but as a topic that has been around since the 1980s without significant changes, industry stakeholders are looking for fresh angles on a legacy problem. Besides the OB bundle, the maternity space will not fully depart from a fee-for-service model any time in the near future. We need new methods of measurement that don’t focus solely on compliance with process-oriented outcomes, but also incentivize an attitude of sensitivity to lived experience and personalization of care.
Interested in hearing more about how Babyscripts is giving patients access to engaged and equitable care? Ready to maximize the value of your digital tools? Watch for our webinar on "Health Equity, Engagement, and ROI."