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Why Telemedicine May Have A Role In Pregnancy Care In Texas

This winter, I attended a conference to learn more about telemedicine, or caring for patients over video, phone, or the internet. I was curious about it – in a state the size of Texas, it makes sense to use technology to bring care to the patient, instead of making the patient come to a doctor. I think it’s definitely the next big patient-focused arena for pregnancy care.

Many health care organizations already use telemedicine for acute care. Here in Texas, there has been some interest in telemedicine options for high-risk pregnancies because access to specialist doctors in rural communities is limited. A program piloted in Arkansas has made an impact on this very problem, and I envision something similar could greatly benefit women in Texas. 

The Arkansas Antenatal and Neonatal Guidelines, Education, and Learning System (ANGELS) program has connected women who have high-risk pregnancies with specialists across the state for telemedicine and real-time ultrasound consultations. These women don’t have to travel several hours to see a specialist. Their local doctors can perform ultrasounds and send the images securely to a specialist for review. Patients can have genetic counseling, even when there’s no counselor in their part of the state. In this way, ANGELS has improved specialist access in Arkansas, and preliminary data suggest that more high-risk pregnancies are being detected in the first trimester instead of later in pregnancy. That means more mothers and babies are referred to specialized care much sooner.

How telemedicine can work for pregnant women in Texas

There are so many opportunities for telemedicine in Texas. ANGELS has proven that it works for ultrasound consultation. We could see patients via telemedicine for many of the special and day-to-day high-risk pregnancy tests and steps, including:

  • Electronic medical record (EMR) consultations: Reviewing and making recommendations for care based on a patient’s medical history and test results, all of which are detailed in the EMR
  • Genetic counseling: Talking with patients about their risk factors for passing genetic conditions to their babies
  • Videoconferencing: The doctor and patient can discuss findings during ultrasound examinations face-to-face over video.
  • Virtual rounding: Being at an inpatient’s bedside across the state through mobile device technology

These ideas are hospital-based, but the reality is that most people have a mobile device, and telemedicine easily could take place in the patient’s home. More than three-fourths of all Americans own a smartphone, and that kind of connectivity lends itself well to telemedicine. 

How patients can benefit from telemedicine

The benefits of telemedicine are abundant for pregnant women. Patients can:

  • Take less time off work because they won’t have to travel to routine appointments – video or telephone consultations can be done anywhere there is internet and privacy
  • Get high-quality health care without having to leave the home or community
  • Avoid sitting in the waiting room with potentially ill patients
  • Access and send EMRs and messages to their doctors through secure systems, such as Epic

Telemedicine isn’t just for people who live in remote areas, though. At last year’s national ACOG meeting, results were presented from a study that replaced some routine prenatal visits in low-risk patients with a device that recorded weight and blood pressures at home. This group was compared to traditional care. Patients using the device had about 6 fewer visits to the doctor’s office and were more satisfied with care. Nothing bad happened to either group receiving care.

It’s interesting to see generationaldifferences when I talk about the results of this study. Older nurses in myoffice thought the idea was terrible, that patients would not be happy withthis practice, and that patients need to physically come into the office. Mydaughters, on the other hand, are 20-somethings who thought that usingtechnology to avoid having to physically show up in a doctor’s office wasgreat.

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