This month, Babyscripts was featured in the Wall Street Journal article Digital-Health Startups Take Aim at the Maternal Health Crisis.
The piece highlighted startups in women's healthcare that are addressing maternal health issues -- including some contributors that aren't always included in the conversation but should be, like access to care or social determinants of health.
Digital health technologies are not a substitute for a physician's care, as some tech enthusiasts have celebrated or nay-sayers have warned, depending on which side of the issue they fall on. They are instead a critical supplementary tool, providing efficiencies that enable physicians to operate at the top of license. Their primary value lies in extending the reach of the care provider, reducing administrative burdens and enabling a provider to deliver wraparound, individualized care to a patient without continuous oversight on the physician's part, or more time spent in the office.
The primary drivers of the maternal health crisis are not clinical failures, especially in regards racial disparities in outcomes. Pregnancy care is highly standardized and regulated. For the most part, women are receiving the same care regardless of their healthcare provider. To get to the root cause of the dramatic disparities that exist in maternal health outcomes (Black mothers die from pregnancy-related complications at 2-3x the rates of their White peers), solutions need to address the variables — everything external to clinical care, and external to the pregnancy period itself.
One of these risks is access to that clinical care:
“In the United States, access to pregnancy care is not equal and technology can help solve some of those challenges,” said Dr. Kathaleen Barker, assistant professor of obstetrics and gynecology at UMass Chan Medical School-Baystate. Baystate Health, a health system in Western Massachusetts, uses Babyscripts technology.
It's in the times between seeing their care providers that mothers are most at risk, where the preventable 80% maternal deaths typically originate. Eclampsia, for example -- thought to be the cause of Olympic sprinter Tori Bowie's recent tragic death -- can strike like lightning (in fact, that's where its name is derived) but is typically preceded by warning signs. Yet many women don't understand their risks, know when and how to look for the warning signs, or have the tools to identify them.
One of the most significant signs is high blood pressure -- in fact, blood pressure complications are related to 1/3 of maternal deaths. Providers are vigilant about monitoring for BP at in-person appointments, but their in-person reach only extends to the appointments on the schedule. And that's assuming that a mother shows up for all of them -- a best case scenario that frequently does not match reality, especially in the postpartum period when mothers are the most overwhelmed and also at the highest risk.
A solution like Babyscripts exists to fill those gaps between appointments, helping the care provider work with the mother to self-monitor their blood pressure. Babyscripts reinforces provider education and recommendations with resources explaining the importance of monitoring, how to interpret symptoms, reminders to adhere to BP recording, and a trigger alert system that communicates potential emergencies back to the provider.
Delivering certain aspects of care remotely also targets the growing physician and nursing shortage:
Dr. Kathryn Marko, associate professor of obstetrics and gynecology at George Washington University School of Medicine and Health Sciences, said the technology has helped reduce the need for office visits for some patients, freeing capacity in her practice for people who need in-person interventions. “We now have the capacity to schedule them more readily,” she added.
The national footprint of Babyscripts and other startups mentioned in the article show that the appetite for digital health technology exists -- health systems are prioritizing digital health strategies across the country -- and the data shows that they are actually moving the needle on outcomes. But the variability of regulations and reimbursements across state lines is a serious obstacle for providers who want to take advantage of digital opportunities, and more work needs to be done to address the challenges and get these tools into the hands of patients.
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