With the nation’s maternal mortality price rising, hospitals are turning to textual content messages to make a reference to at-risk moms.

With latest information that the maternal death rate rose significantly in 2021, healthcare leaders are searching for revolutionary and efficient methods to attach with at-risk mothers-to-be and collaborate on higher care administration and outcomes.

In Dallas, the highlight is on the Preterm Birth Prevention Program launched in 2018 by Parkland Hospital and the Parkland Center for Clinical Innovation (PCCI). The program, which impacts some 13,000 mothers-to-be a yr, makes use of knowledge on social drivers of well being (SDOH) to determine at-risk girls and develop focused interventions aimed toward bettering care.

“Healthcare itself only accounts for 15% to 20% of health outcomes,” says Yolande Pengetnze, MD, a pediatrics specialist and PCCI’s vice chairman of scientific management. “True health … comes outside of the health system. That’s where we need to be.”

The program is one among many being deployed by well being techniques and payers throughout the nation to sort out the excessive maternal mortality price, particularly amongst underserved populations. Many of those efforts are trying exterior the standard boundaries of scientific remedy to group and cultural elements that have an effect on healthcare, together with employment, housing, transportation, schooling, daycare, welfare, cultural biases, and different elements that have an effect on healthcare entry.

Parkland’s program tracks socioeconomic and demographic elements and scientific knowledge to determine pregnant girls liable to preterm supply. The knowledge additionally helps suppliers at Parkland design customized care plans that meet each the care group’s wants and the affected person’s preferences.

“An informed patient is the best patient in healthcare,” says Pengetnze, who notes that previous to utilizing this expertise, “we’d wait for them to come to the doctor.”

Yolande Pengetnze, MD, vice chairman of scientific management, Parkland Center for Clinical Innovation. Photo courtesy PCCI.

The program is run by a well being plan, which makes use of its database to display for social drivers of well being (SDOH) and make that first connection to sufferers by their care managers and textual content messaging. From that time, the affected person is directed to a variety of care administration assets, and are even linked to a social employee if wanted. In addition, a care group at Parkland is introduced in to handle scientific interventions.

“We’re trying to create some sort of continuum of care for these patients and be proactive,” Pengetnze says. “We want to be able to identify these problems before they come to the doctor.”

The program makes use of customized textual content messages like the next:

• Remember to take your prenatal nutritional vitamins on daily basis! Prenatal nutritional vitamins aid you and child get all the nutritional vitamins and minerals you want for wholesome progress.  
• Doctor’s visits are a good time to ask all of your questions on being pregnant! Bring an inventory of something you need to know. 
• In the third month, child would be the dimension of a peach! 
• Ask your physician concerning the indicators of labor at your subsequent physician’s go to. It is useful to know the indicators of labor to know when to begin getting ready. 
• Stay Safe! Make positive to put on your seatbelt beneath your stomach and over your hips, NOT over your stomach. Also strive to not drive greater than 5 to six hours a day. 

Pengetnze says the messages are despatched two to 3 instances per week, generally extra usually for ladies deemed at excessive threat.

And this methodology has labored. According to officers at Parkland, the interventions have helped to cut back the preterm supply price by 20%, boosted prenatal visits to the physician by some 8%, and decreased prices by 6%. A survey of these collaborating in this system, in the meantime, discovered that just about three-quarters mentioned they felt higher ready to maintain themselves and their new members of the family.

Those percentages are notably vital to the Medicaid inhabitants, which sees the next price of preterm deliveries and problems attributable to entry points. Surveys have proven that socioeconomic elements contribute to emphasize and melancholy, which in flip have an effect on preterm well being.

The problem lies in reaching these underserved populations and figuring out who wants assist. Pengetnze says HIPAA (Health Insurance Portability and Accountability Act) pointers can hinder how suppliers use knowledge and join with sufferers, whereas suppliers usually cannot find or entry the socioeconomic knowledge they want as a result of sufferers are reluctant to supply that data. And since textual content messages aren’t safe communications, this system wants consent from the affected person earlier than sending them.

“Some women don’t even want it known that they are pregnant,” she factors out. “With SDOH, some data elements are sorely missing in the system. The EHR is a good platform, but we need technology that can collect that type of data and standardize it.”

Noting the success with at-risk pregnant girls, Pengetnze says the platform can be utilized to focus on different populations and well being considerations.

“The [text messaging] platform is good because it’s simple, and that’s what we need to reach out to these populations,” she says. “We need to make it simple for them [to connect], and then we’ll do the complex part. Any additional step in that process increases the risk of losing that patient along the way.”