Redesigning Prenatal Care: A National Project to Improve Equity in Prenatal Care Delivery
As the Coronavirus pandemic has moved across the globe, telemedicine interventions in healthcare have become an integral part to the clinical and public health responses for the pandemic. Specifically, involving prenatal care delivery where little policy change has occurred since the early 20th century, telemedicine has become a catalyst for the largest shift in patient care on both the practical and policy front. The Michigan Plan for Appropriate Tailored Healthcare in pregnancy (MiPATH) team at the University of Michigan (U of M) conducted six systematic reviews utilizing the PICOS (Population, Intervention, Comparator, Outcomes, and Setting) for study inclusion/exclusion. The resulting data following abstraction was rated utilizing the Rand Corporation – University of California, Los Angeles (RAND-UCLA) Appropriateness method covering interventions in telemedicine, remote monitoring, and frequency of visits across both low and high-risk patient populations. The data was evaluated by a panel comprised of experts in realms of policy, clinical practice, and patient representation and following evaluation crafted an updated clinical guideline through the American College of Obstetricians and Gynecologists (ACOG). Articles involving telemedicine interventions meeting the requirements for inclusion were found to be of high incidence with fifty articles ultimately captured in the review. Overall, telemedicine interventions saw positive impacts in the management and monitoring of high-risk conditions such as diabetes, reductions in patient visits, and patient satisfaction. Through the review conducted, future applications of telemedicine in prenatal care are expected to be utilized, even following the Coronavirus pandemic.
