A template approach to managing the majority of pregnancies was introduced in the late 1970s by the Institute of Medicine (IOM), with the intention of improving pregnancy outcomes through increased visits to the doctor - approximately 14 visits per pregnancy. But this "one-size-fits-all" approach to prenatal care drives up costs, and can be an unnecessary burden for busy women.
Startups like Babyscripts, the first mobile, clinical tool to allow OB/GYNs to remotely monitor their patients' progress and health, and OB Nest, a Mayo clinic initiative to transform prenatal care from a medicalized model to an innovative wellness model, have created a new template that uses technology and big data to facilitate intuitive risk-based care.
The Babyscripts platform is unique because it's aimed directly at clinicians and their patients. Patients receive a "Mommy Kit" with an FDA-approved WiFi- and Bluetooth-enabled blood pressure cuff and weight scale. The app directs patients to take their blood pressure and weigh in regularly so that issues such as high blood pressure or too much weight gain can be identified earlier, not just when a woman shows up for her monthly prenatal appointment. The app monitors patient related data and communicates exceptional data points on a real-time basis. It even deploys a personalized approach to specific types of patients based on their conditions and needs. For example, postpartum content and depression screenings to patients who need this.
The OB Nest initiative allows women experiencing low-risk pregnancies to reduce their number of in-person visits from the standard 12-14 to just eight. The custom IT solution pulls together everything providers need to know regarding preexisting health, as well as a plan for follow-up visits and related information. An electronic dashboard allows providers to easily track and organize their patients according to their needs. The Mayo Clinic can now quickly identify patients with a high risk of complications during pregnancy and make necessary care plans.
Both Babyscripts and OB Nest have proven that by re-assessing the traditional structure of prenatal care, current technologies like smartphones and internet-enabled medical devices are the key to facilitating the transition to a more risk-appropriate prenatal model, in a timely and transformative fashion.
This new template enables providers to automate certain parts of their care, facilitating the reallocation of time, attention, and resources to the most high-risk patients. Traditionally, pregnancy has been approached as a disease - yet most most patients will not suffer a single complication during their pregnancy.
So why do we preserve a system that currently treats all patients as if they were going to be diagnosed with a problem, as opposed to only certain patients with either a history of complications or certain high-risk factors at the onset of the pregnancy like twins, hypertension, or diabetes.
The Precision Medicine Initiative, introduced by President Obama in 2015, was a radical approach to medical research intending to facilitate personalized health care. This research program leverages the advances in technology that have emerged in the medical community - the large-scale biological databases, such as the human genome sequence; the increasingly sophisticated methods of classifying patients; and the computational tools for analyzing large sets of data - to prevent and treat diseases based on the variabilities of genes, environments, and behaviors. Essentially, the idea is to move medicine to a personalized care model like the current models created by Babyscripts and OB Nest for precision prenatal care.
How Does the Babyscripts Model address Precision Care for Everyone? What does the future look like?
"The way to improve pregnancy outcomes is to start with providers of care, creating pathways and procedures that enable clinicians to focus the majority of their time and energy on high-risk pregnancies, while receiving assurance of the health of their low-risk patients," said Juan Pablo Segura, co-founder and President of Babyscripts. "The industry has been evolving, with new approaches to managing pregnancy through nurse mid-wives or group prenatal care (like centering), but more must be done to liberate practitioners from an antiquated model."
Current technologies like smartphones and internet-enabled medical devices are the key to facilitating the transition to a more risk-appropriate prenatal model, in a timely and transformative fashion. By leaning on current technologies like blood pressure cuffs, weight scales, and glucometers that are connected to the internet, providers can generate the needed confirmation that patients are healthy in between visits, while focusing their time on the sickest and most vulnerable patients. The exact same model could be applied to any standardized healthcare practice. Precision care is the future of healthcare and digital health technology, and the means of achieving it for all patients could be as attainable as a smartphone.