Improving patient monitoring through care-at-home services could help reduce maternal mortality, they say.
The United States is home to one of the most advanced healthcare systems in the world, but when it comes to maternal mortality, progress has proven particularly difficult.
A study published last month in the Journal of the American Medical Association, found maternal mortality in the United States remains “unacceptably high” – particularly among American Indian, Alaska Native, and Black populations.
And despite advancements in other parts of healthcare, the maternal mortality rate increased over the past two decades. For instance, the median state maternal mortality rate among Black patients was 26.7 maternal deaths per 100,000 live births in 1999, but by 2019 the rate had risen to 55.4 maternal deaths per 100,000 live births. The study said recent efforts in many states to prevent maternal deaths “appear to have had a limited impact.”
Chris McGhee, MEng, MBChB, said one part of the solution is careful monitoring of patients with high-risk pregnancies. However, he said adequate monitoring can be burdensome to patients.
“You have women who are driving to the clinic, and in some cases driving quite some distances just to get their blood pressure taken,” he said.
McGhee is the chief executive of Current Health, a care-at-home company that offers technology solutions for a variety of healthcare situations, including high-risk pregnancies. He said the burdens of frequent clinic visits leads some patients to opt against seeing their doctors, even when they feel something is not right with their pregnancy. It also leads to patient dissatisfaction with the healthcare system, McGhee said.
“The knock-on clinical and economic consequence for these women is everything from morbidity to maternal death, but also premature delivery,” he said. “And the cost of premature delivery is enormous.”
Current Health’s platform is designed to allow patients and healthcare providers to track key health metrics from afar, reducing the need for in-clinic visits. In the case of high-risk pregnancies, that means monitoring patients for signs of severe hypertension or new-onset postpartum preeclampsia, among other complications.
McGhee outlined a hypothetical case in which a patient’s blood pressure was found to be abnormally high.
“An alert would be generated, and that would be sent to either our clinical command center… or it would be sent to the clinician, and the patient would be contacted and routed to the most appropriate place,” he said, whether that be their primary care physician, their OB-GYN, or a hospital.
In some cases, though, clinicians might simply choose to keep monitoring patients, thereby allowing them to avoid a trip to the clinic.
“Or maybe they’re going to give medications, but actually, do you need to come into the clinic for that?” he said. “Maybe we can send the prescription to your local pharmacy and again, avoid you having to make a trip to the clinic.”
Maternal health is just one of several categories of patients Current Health’s platform can monitor. What unites the different disease categories, he said, is the opportunity to lower healthcare costs while also removing the burden on patients.
The company markets its products to healthcare organizations, as a means of lowering their costs and reducing inpatient hospitalizations. He said payers are also enthusiastic about the role of care-at-home.
“It’s very clear that they see the home and convenience as a big part of their strategic future.
He noted that United Health Group recently agreed to acquire the home health company Amedisys.
Current Health has also benefited from the increased interest in care at home. Two years ago, the electronics retailer Best Buy purchased Current Health as part of its expansion into healthcare. McGhee said the deal made “natural sense” because Best Buy has the technical know-how to support home-monitoring technology, as well as the workforce to install and service the equipment in patients’ homes through its Geek Squad service.
“There’s literally no one who is better placed than Best Buy to do this because of Geek Squad and because of the experience they have with installing and supporting technology in the home,” he said.
And while providers and insurers see care at home as a means to lower costs and boost efficiency, McGhee said he believes patients are increasingly seeing such services as an expected part of the healthcare experience in the post-coronavirus disease 2019 (COVID-19) pandemic era.
“Because during COVID… our patients experienced that they could get more virtual care, and they could get care in their own home, and they could get care in more convenient locations,” he said. “And I think that’s led to patients saying, ‘I’m not going to give up on that more convenient healthcare I had during COVID now that COVID is passed.”