With persistent gaps in care, widening outcome disparities, and limited access, particularly in rural communities and among minority women, maternal care remains in crisis.
At the same time, provider shortages continue to strain health system operations, accelerating the adoption of telehealth as a force multiplier.
To explore how virtual care can help address these challenges, Becker’s Healthcare spoke with Blake Porter, MD, chief of maternal-fetal medicine at Access TeleCare.
Note: Responses have been edited for length and clarity.
Becker’s: Where are hospitals seeing the greatest impact from tele-maternal-fetal medicine (MFM) today and how has this care model evolved over the past several years?
Dr. Blake Porter: Elevating inpatient care is the most obvious benefit of being able to deliver MFM virtually. Tele-MFM extends sub-specialty care directly to the bedside, regardless of a patient’s location. The result: women receive above standard of care medicine in the right setting for their babies.
Virtual MFM can also significantly impact the outpatient space. It’s possible to run virtual outpatient MFM clinics once or twice a week in communities where a sub-specialist isn’t needed every day. This expands access, while allowing women with maternal medical conditions to stay in their communities.
Q: How does tele-MFM change the experience for pregnant patients and families, especially those in rural or underserved communities who may otherwise lack access to high-risk obstetric care?
BP: The greatest impact is that pregnant patients and their families are able to get care they otherwise wouldn’t have access to. With telehealth, patients are able to receive the care they deserve, regardless of where they live.
Tele-MFM doesn’t just benefit individual patients; it also positively affects entire communities. Communities take pride in health systems that invest in virtual sub-specialty services and deliver outstanding care. Everyone wins when community members have access to great pregnancy care.
Looking ahead, the Rural Health Transformation (RHT) Program has the potential to transform maternal care. Many states view maternal health and MFM as top priorities for RHT funding. This is an opportunity to provide high-quality care to rural areas.
Q: Many hospitals struggle to recruit and retain MFM specialists. How does tele-MFM help health systems stabilize or expand high-risk obstetric services without overextending the workforce? Can this approach positively impact rural providers?
BP: Annually, across the entire country, only a few hundred new MFMs join the clinical workforce and most of these specialists work in metropolitan areas. As a result, there aren’t enough MFM specialists in the United States to support all of the mothers who need care. The obvious solution is technology.
Many communities need an MFM, but don’t have enough patient volume to support a specialist for even one full day each week. With a fractionalized tele-MFM care model, one virtual MFM can deliver care at multiple hospitals in a single day.
Tele-MFM helps rural providers by stabilizing their labor and delivery units. Through this model, providers have access to the clinical specialists needed to practice safe medicine, reassuring obstetricians and pivoting care plans, if necessary. It’s easier to recruit and retain providers when they have 24/7 access to an expert. Access TeleCare’s MFM sub-specialists can be at the bedside consulting virtually within minutes.
Q: Persistent maternal morbidity and mortality disparities remain a nationwide concern. What role does tele-MFM play in improving maternal health equity? How does expanded access to specialty expertise help close gaps?
BP: One reason why disparities in health outcomes arise is because some people lack access to the expert care they need. The solution is delivering care virtually in communities to the patients who need it.
Medical directorships are another way to elevate care at rural health systems. I have an active medical directorship at many client sites. Each month, I participate virtually in quality and patient safety reviews, morbidity and mortality conferences and patient prep conferences.
Q: How have tele-MFM and advanced ultrasound or sonography helped identify risks earlier or significantly improved outcomes for mothers and babies?
BP: My team offers remote ultrasound readings to determine if babies have problems that need to be addressed. Access TeleCare’s dedicated advanced practice sonography (APS) team is MFM trained. Our sonographers have certifications in detailed fetal anatomy screenings, fetal echocardiography and other areas. Our team members work side by side with local, in-person sonographers to elevate the local provider’s imaging capabilities. Then our MFM sub-specialists read the images.
Our APS team increases local abnormality catch rates by 8% to 9%. That means we routinely pick up abnormalities that in-house teams didn’t see. It’s a massive value-add for health systems.
With our expertise, we’ve detected complex congenital heart disease, as well as brain abnormalities. By identifying defects early, we ensure women deliver in the right setting. That’s important because babies with serious health issues are at higher risk of long-term complications if they’re transferred to another facility after birth.
Q: For hospital leaders considering tele-MFM, what operational or cultural barriers tend to surface? What strategies work to integrate tele-MFM and advanced sonography into existing care teams?
BP: You must identify why people are resistant to change, then show them how technology and access to experts can improve outcomes and workflows, reduce stress on the care system and keep more deliveries local.
Access TeleCare seeks to understand the culture and operations at every healthcare system. We meet people where they’re at and show how Access TeleCare can help with their challenges.
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