In the last several years, worsening maternal outcomes have highlighted the failures of traditional maternal healthcare delivery and motivated discussions around better methods and models for patient care.
Risk is one of the most significant pieces of that conversation — how it is defined, how it is identified, how it is addressed — and who ultimately is responsible for managing it.
The answer to that last question, according to a panel of experts hosted by Babyscripts, is everyone — beginning with an empowered patient. It seems like a simple answer, but it comes with a host of challenges, including communication between care team members, reimbursement for resources, and access to support after a risk is identified.
The panel included Rosalyn Carr Stephens, RN, MSN, and Corporate Clinical Director of Population Health Clinical Operations at AmeriHealth Caritas; Adriane Burgess, PhD, RNC-OB, and Director of Perinatal and Neonatal Quality and Safety at the Maryland Patient Safety Center; and Haywood Brown, MD, Senior Associate Vice President at USF Health Faculty, Academic Affairs and Vice Dean at Morsani College of Medicine. They offered their insights on these issues and others, sharing their perspective on risk from different aspects of the care continuum.
“Women and children don’t just live in a service line.”
Risk management is the responsibility of everyone on the care team.
Clinical variables account for about 20% of maternal health risk. The other eighty-percent is related to social determinants of health, behavioral health, and other challenges that often don’t get addressed in the space of an OB/GYN appointment. Some problems are not immediately observable, and patients may be afraid or embarrassed to talk about them, like food insecurity or intimate partner violence. Training colleagues in other specialties (non-OB providers, emergency departments, midwives, lactation consultants, etc.) to assess risk in pregnant and postpartum women is crucial for prevention, as it can sometimes take many eyes and many questions to identify risk. Communication between the entire care team ensures that everyone has a complete picture of that patient’s health and potential complications.
At Amerihealth, Babyscripts is a tool to connect “not only our team of care managers and care coordinators to identify what that risk is and addressing that risk as early as possible, but also making sure that there's a pathway to provide that information to others in the care team,” shared Rosalyn Carr Stephens. “Whether it's the OB physician or the team at Labor and Delivery or anyone else that's part of a care team for that individual.”
“Thirty-six percent of women of reproductive age live in counties where there is no practicing OB/GYN and no hospital.”
Access and cost are two challenges in the context of maternal risk.
During the discussion, a key insight emerged: one of the primary obstacles in evaluating maternal risk begins with the difficulty patients face when trying to access prenatal care. Many individuals encounter significant challenges in locating and reaching a healthcare provider during the crucial first trimester of pregnancy, and even when they succeed, navigating the complexities of insurance coverage can pose additional hurdles. This is where community-based caregivers can play a critical role. To be most effective, they need to be connected to the larger care team. Digital health solutions can facilitate data exchange between clinicians, physician-extenders, and payers to ensure better access to resources and care.
standardized assessments warrant standardized tools.
One of the biggest challenges in risk assessment is consistent capture and executing interventions. When it comes to behavioral health risk, many patients get missed — NICU mothers and postpartum mothers are especially vulnerable to being overlooked. Some providers of care might be reluctant to make an assessment at all, because they don’t have the resources to support the intervention. Our panelists agreed that standardized assessments are essential for offering consistent care and closing health disparities, and that telehealth is a pathway for delivering both assessments and interventions.
Empowered patients are the key to better health outcomes.
Pregnancy and postpartum is a unique episode, where individualized care allows patients to feel empowered to improve their own health. In addition to listening carefully to patients to assess risk, remote monitoring is a tactical solution that allows patients to have more control over their care and empowers them to improve their own health.
“I think that's the part that is amazing about a program like Babyscripts - and remote patient monitoring. [...] You're giving the patient the tools they need to advocate for themselves and to be able to risk assess — to be able to engage in care, and to self advocate. And [...] there shouldn't be barriers to anyone to be able to do that.” -Adriane Burgess
How Babyscripts assess risk
Babyscripts identifies risk through remote monitoring and screening, addressing barriers of access and key health metrics that drive disparate outcomes like blood pressure, mental health, and social determinants of health. Our data-driven trigger alert system is not subject to biases of human interpretation, ensuring an equitable response to risk. Actionable patient data is delivered directly to providers of care, saving them time and preventing data overload. This aligns with the needs of safety net healthcare organizations, which often face resource constraints and increased patient volumes.
In response to reported risks, Babyscripts dynamically guides the patient journey through care pathways, which create the opportunity for improved quality of care without additional administrative burden, and ensure that patients receive appropriate care at every stage of their treatment. They standardize and streamline care processes, reducing unnecessary tests, procedures, and hospital stays, which can result in cost savings. They promote consistency in care, reducing variations and errors in treatment.
Interested in hearing the whole conversation between our panelists? Listen to the recording here.
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