The United States is in a maternal health crisis. With the worst maternal mortality outcomes among high-income countries, the healthcare industry cannot afford to continue leaning on the traditional models of care. These models focus on individual risk without understanding the factors that affect health at a population level. But health outcomes are impacted by so much more than just healthcare. In fact, numerous studies suggest that medical care accounts for only 10-20% of the modifiable contributors to health outcomes across a population.
Population health (the health outcomes of a group of individuals and distribution of those outcomes), helps us to see the health patterns across populations more clearly. Maternal mortality rates are inextricably linked to the population-health challenges, such as chronic disease, lack of access to care, and social determinants of health, that plague our health system. To begin to address these challenges, the healthcare industry needs to innovate on the traditional methods of delivering care and look toward models that extend the reach of the doctor’s office.
No one healthcare or public health organization has the capacity to address these issues on its own.
Take, for example, cardiovascular disorders, the leading cause of maternal mortality in the United States, accounting for 33% of maternal deaths (nearly 70% of which are estimated to be preventable). Prevention of cardiovascular disease in pregnancy often centers on individual-level solutions, such as in-person prenatal visit adherence or diet and exercise. While critical to saving lives, this individual approach does not acknowledge the countless barriers that stand in the way of these recommendations This approach also ignores the structural flaws in the way we deliver maternity care that continue to put more moms at risk. Leveraging digital health is one way to resolve this issue.
The Role of Digital Health Solutions in Population Health
Increases Healthcare Access through New Care Delivery Models
Of the cardiovascular disorders that impact pregnancy outcomes, pre-eclampsia is the greatest contributor to maternal mortality. Early detection of pre-eclampsia through prenatal monitoring is critical to the health of mothers and children, however physical access to care is impeded by many barriers such as work and childcare. Remote-patient monitoring (RPM) of blood pressure breaks down barriers to access and provides another avenue for early detection of pre-eclampsia giving patients peace of mind through the knowledge that their provider is monitoring their health throughout their pregnancy.
Additionally, RPM can improve the allocation of resources for in-person care. For Black women, who are more likely to suffer from blood-pressure related complications during pregnancy and postpartum, RPM may also provide new avenues to address historical mistrust in the medical system. Research has already shown that the increased use of virtual health has boosted access to follow-up visits for Black patients.
Addresses Social Determinants of Health
Research has consistently shown that social determinants of health (SDOH) – “the conditions in which people are born, grow, work, live, and age” – play a larger role in determining health outcomes than healthcare access and services, especially at the population level. SDOH like transportation, social support, and housing can make it difficult to attend prenatal visits and access critical prenatal care.
The Plan for Appropriate Tailored Health Care in Pregnancy Prenatal Care Recommendations (PATH) released by ACOG emphasizes the importance of both clinical and social risk assessments as early as possible in pregnancy to ensure identification of risk factors, connection to services, and care planning. Digital health can enable earlier and more comprehensive data collection and identification of social needs that impact health. Building this population-level understanding to better meet the needs of women can help to better inform care and improve systems.
Facilitates More Connected Care
Population-level maternal health requires looking beyond the doctors’ office and connecting across stakeholders, such as organizations like WIC that deliver ongoing health, wellness, and social support, and have been shown to have a strong influence on patient behavior. Digital health can help to facilitate more efficient, timely data sharing to break down silos across stakeholders, leading to better access to resources, follow up care, and more actionable insights.
No single healthcare organization across public health, healthcare, and social services has the capacity to address population health consistently at scale. Digital health enables the access, partnerships, resources, and data-sharing necessary to do so. To change the future of healthcare we need to think bigger and invite disruption to improve health outcomes. Digital offers an opportunity to address population-level problems while maintaining a patient-centered lens.
Tracey Kirui is participating in the Babyscripts Summer Internship program working with the Strategy and Operations Team. She is pursuing a Master of Public Health at the University of California at Berkeley, with a focus in Health Management and Social Behavior. In her free time she loves to hike, try fun new vegetarian recipes, and day dream about better healthcare.