Remote patient monitoring (RPM) is gaining ground and securing its permanency within our evolving healthcare system. Ideal for patients who need close monitoring of their ongoing health concerns, RPM can play an essential role in keeping patients healthier for longer and avoiding the acute exacerbations that can land them in the emergency room or hospital.
In short, remote patient monitoring is an easy and cost-effective solution that can be used to care for patients with chronic diseases like diabetes, obesity, heart disease and hypertension, asthma, and chronic obstructive pulmonary disease (COPD). With its versatility and cost-effectiveness, it was only a matter of time before RPM would cross over into a wider variety of specialty healthcare arenas, which is why it comes as no surprise that remote patient monitoring is now finding a place in the practice of obstetrics to help support pregnant women who have been diagnosed with gestational hypertension and/or gestational diabetes.
Complexities of Pregnancy Care
Worldwide, the rates of maternal morbidity and mortality have improved drastically over the last century, but here in the United States, unfortunately, our rates have worsened. The American healthcare system contains many barriers to care for the average person, but pregnant women experience even more obstacles. Lack of insurance, transportation, time constraints, and dwindling numbers of obstetric practitioners are just a few of the issues that can keep pregnant women from receiving the critical, early prenatal care they need to better ensure a healthy pregnancy and baby.
While the practice of obstetrics will never have a shortage of patients, there is a very real shortage of practitioners who choose to specialize in this area of care — one that is building at an alarming rate. According to the Association of American Medical Colleges (AAMC), there were around 8,000 fewer OB-GYN practitioners than were needed in 2020, and that number is expected to rise to about 22,000 by the middle of the century. Riddled with high malpractice premiums and worsening maternal/fetal health outcomes, obstetrics has become a field of practice that many new practitioners avoid.
But for those who admirably pursue a career in OB-GYN, solutions like remote patient monitoring are helping improve quality of patient care. Let's look at how RPM supports patients with gestational hypertension and gestational diabetes.
Remote Patient Monitoring for Gestational Hypertension
High blood pressure in pregnancy is common in the United States, and according to the Centers for Disease Control and Prevention (CDC), 1 in every 12 to 17 pregnancies is complicated by rising blood pressure numbers. High blood pressure during pregnancy can lead to dangerous complications for mother and baby, including preeclampsia, eclampsia, stroke, and preterm delivery. Controlling climbing blood pressure numbers is key to keeping them both safe and healthy, but the tedious frequency in which blood pressure should be monitored during pregnancy and post-delivery can become an obstacle for many pregnant women and their practitioners. For pregnant women who work or have other responsibilities, the increased frequency of office visits and the need for tedious tracking and reporting of blood pressure numbers can become a barrier in maintaining the level of care needed and place both mom and baby in jeopardy.
According to Fran Ayalasomayajula, founder of Research for Equitable Antenatal Care and Health (REACH), one of the best tools we have against hypertension in pregnancy is blood pressure monitoring. Since not all women show outward signs in climbing blood pressure, it's crucial for close monitoring throughout the third trimester, and sometimes beyond. To provide all pregnant women with blood pressure monitoring devices would require buy-in from key stakeholders, such as practitioners, payers, and patients. But the good news is that the technology already exists, is easy to access, and is a time-saving and cost-effective solution for everyone involved.
Remote Patient Monitoring for Gestational Diabetes
Per the CDC, between 6 to 9% of pregnant women in the United States will develop gestational diabetes during their pregnancy, with the trend increasing in recent years. The most effective way of mitigating the effects of gestational diabetes on mother and baby is through frequent and close monitoring of blood glucose levels, nutritional tracking, exercise, and, if warranted, medication and/or insulin injections. If not effectively controlled, high blood sugar numbers are very dangerous for mother and baby, and can lead to an abnormally large baby, shoulder dystocia or other birth injuries for baby, the need for a cesarean birth, preterm labor, high blood pressure and preeclampsia, macrosomia, premature birth, and even stillbirth.
For expectant moms with gestational diabetes, the diagnosis means extra, more frequent visits with a nutritionist and their obstetrician, making pregnancy more cumbersome and time consuming. Pregnant women who work, live rurally, or lack insurance coverage can find that receiving this extra care is difficult and expensive, causing them to not adhere as closely to their treatment plan as they should. Remote patient monitoring can reduce the effects of these barriers, making the extra care easier to achieve for pregnant women and their healthcare team.
Finding Much-Needed Help With Remote Patient Monitoring
Developing a remote patient monitoring program for patients who've been diagnosed with gestational hypertension and/or gestational diabetes can help practitioners and patients alike. Obstetrics is a busy field of practice with dwindling numbers of new practitioners. The result is busy obstetric practices that are busting at the seams with a never-ending flow of patients that require regular and frequent care. Busy obstetric practitioners are constantly pulled between office visits and hospital deliveries, making the chore of maintaining regular practice schedules challenging at best. The ability to monitor patients with gestational hypertension or diabetes with the use of RPM technology will free up crucial time for practitioners and help them share the burden of care with their qualified staff.
Remote patient monitoring can also help reduce access barriers for pregnant women, making adherence to recommended treatment regimens easier and more effective. Since remote patient monitoring technology uses smart devices that collect and transmit data over a Wi-Fi or cellular network directly to the healthcare team, the tedious tracking of blood pressure readings and blood sugar numbers can be sent to their practitioner in real time, eliminating errors and patient omissions. Even better, those readings can be received immediately by the healthcare team, making it easier to catch and react to concerning trends quicker, thus resulting in better control and fewer emergency situations.
Remote patient monitoring is already a gamechanger for an array of patients with chronic diseases, making their care more effective in quality and cost. Now we are seeing RPM crossing over into other realms of specialty healthcare and being leveraged in new ways, like pregnancy. With strong buy in from practitioners, patients, and payers, RPM is here to stay and can help your practice achieve better health outcomes for your patients.