By Eric Wicklund, mHealth Intelligence | August 2, 2019
Connected health services for new and expectant mothers are all the rage in telehealth circles these days, with several bills aimed at improving telehealth access in rural regions and a new study aiming to determine whether a popular mHealth app helps improve outcomes.
This week, US Senators Shelley Moore Capito (R-WV), Tina Smith (D-MN), Lisa Murkowski (R-AK) and Doug Jones (D-AL) introduced the Rural Maternal and Obstetric Modernization of Services (MOMS) Act, designed to “help ensure that new and expecting mothers living in rural communities have access to the health care they need.”
Among other things, the bill would expand existing telehealth programs to include birth and postpartum services and allow healthcare providers to be reimbursed for their use of ultrasound, fetal monitoring and other pregnancy-related technology.
“New and expecting moms should be able to access quality health care no matter where they live. But right now too many women in rural areas don’t have a nearby hospital with birthing services,” Smith said in a joint press release. “Some people are driving hours – even in dangerous conditions like Minnesota blizzards – just to get to a hospital. We should support moms during this critical time in their lives by fixing this problem.”
“This legislation provides real solutions to expanding care through telehealth grants and other programs to increase the number of health care providers in rural areas, and takes important steps to address our unacceptable rate of maternal mortality in this country,” Jones added.
The bill would also direct the Centers for Disease Control and Prevention (CDC) to study maternal mortality and morbidity; create new grants to establish regional innovation networks to improve maternal mortality and morbidity as well as birth outcomes; establish a new training care demonstration program; and launch studies to identify gaps in maternity care and identify ways to close those gaps.
The bill should not be confused with another MOMS Act, the Modernizing Obstetric Medicine Standards Act of 2019 (S.116). Introduced in January by Senator Kirsten Gillibrand (D-NY), that bill aims to, among other things, create an Alliance for Innovation on Maternal Health program and develop grants to help hospitals and health systems improve their maternal care efforts.
Then there’s the Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act, introduced in May in both the Senate and House, which aims to “improve maternal health outcomes, reverse the trend of rising maternal mortality rates, and close disparities that put mothers and kids of color at risk.”
“The Act takes a comprehensive approach, going beyond putting a band-aid on a broken system, by enhancing available support services and filling gaps in the system that lead to poor health outcomes,” Christy Turlington Burns, founder and CEO of Every Mother Counts, said in a press release issued by Senator Cory Booker (D-NJ), one of the bill’s sponsors. “Because Medicaid covers nearly half of all births in the U.S., this bill has the potential to shift maternity care standards across the board.”
Among other things, that bill would establish a Maternity Care Home demonstration project in up to 15 states and “study telemedicine and its potential to improve Medicaid beneficiaries’ access to maternity care.” It would also direct the Government Accountability Office to study how states are providing telehealth coverage to improve maternal care and offer recommendations for increasing access to telemedicine for pregnant women.
Meanwhile, researchers at Iowa’s Des Moines University and Drake University’s Harkin Institute for Public Policy & Citizen Engagement are launching a research project focused on the Count the Kicks mHealth app. They want to know if the app, developed by the non-profit Healthy Birth Day to track fetal movement and birth outcomes, is improving care management for expectant mothers and their caregivers.
“This project may help us better understand the significance of monitoring fetal movement as part of stillbirth prevention,” Pamela A. Duffy, MD, an associate professor and vice chair of DMU’s Department of Public Health, said in a press release. “We hope this study will be an important contribution to the scientific literature on kick counting and in the reduction of health disparities associated with stillbirth.”
Just last month, researchers in North Carolina, Georgia and Toronto announced a multi-national research project aimed at determining whether telehealth can be used to help new and expecting mothers who are dealing with stress and depression.
The five-year study, funded by a $13.2 million grant from the Patient-Centered Outcomes Research Institute (PCORI), will also test whether a nurse can deliver these services with the same quality of care as a specialist.
“We’re asking whether it matters if the therapy is done by a specialist or a non-specialist, and does it matter if it is done in person or by telemedicine?” Brad Gaynes, MD, MPH, a professor of psychiatry at the University of North Carolina School of medicine and co-investigator for the study, said in a press release. “We’re really testing whether you can get the same outcome from each method of treatment.”