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Wednesday, December 7, 2022
Home Health Wearables Digital Health-How Wearables Can Improve Inequities, Access, and Outcomes in Pregnancy

Digital Health-How Wearables Can Improve Inequities, Access, and Outcomes in Pregnancy

Fareeha Z. Siddiqui, MD, MPH, VP of Healthcare Solutions & Clinical Operations, Biotricity Inc

Pregnant women in the United States are facing an ever-expanding crisis that continues to worsen with each passing year. More women today are dying of pregnancy or pregnancy-related complications than previously. The United States spends upwards of $3.2 trillion dollars/year on healthcare, which accounts for more than 17% of our GDP. One could argue that the quality and care patients receive in the US justify the associated costs. While we spend more than any other country on the provision of healthcare, we provide the least amount of coverage for our population. In addition, the United States has some of the worst health outcomes among developed nations. This is true across all different facets of medicine, but one area where we are particularly failing is maternal health. While other developed nations have seen up to a 43% decrease in maternal mortality, the US continues to see an increase, with maternal mortality rates triple that of other developed nations. Most of these maternal deaths are caused by “Delayed or missed opportunities for treatment. In the US, women have an avoidable maternal mortality rate of 23.8 deaths per 100,000 births. To put this in perspective, Norway had zero. This rate climbs even higher when we account for differences in ethnicity and socioeconomic status.

The growing maternal health crisis can be attributed to the rising rates of chronic diseases, increased emergency cesarean sections, high cost of medical care, and inadequate access to prenatal care. The most significant being the cost-prohibitive nature of our healthcare system. Many women have reported skipping necessary preventive care appointments due to an inability to pay co-pays or take care of their medical bills. Many women are also unable to take time off from work due to fear of job loss or other negative consequences. Rural populations have limited access to healthcare facilities, limited transportation options, and limited job flexibility. Getting adequate access to prenatal care for these women is almost impossible without the use of digital health tools. Preventative screenings and appropriate prenatal care is imperative to a pregnant woman’s health and the baby’s health.

Wearable technologies are becoming ubiquitous and digital health tools now cost a fraction of what a clinic visit costs.  Wearable heart monitors can cost as little as $100-$200 but have the power to detect impending complications and save a mother or baby’s life. Heart disease and premature birth are two of the most common and dangerous complications during pregnancy. Complications from these conditions can often be fatal but are easily preventable.  Heart complications during pregnancy can often have no symptoms or worsen between visits. Using digital health tools like wearables to monitor patients remotely can be the difference between developing a complication or having an uneventful pregnancy.  Pregnant women can attend virtual appointments through telemedicine platforms and not worry about taking time off work or use wearables to share important data with their doctor.  Conditions like Preeclampsia (hypertension during pregnancy) is the number one reason for premature delivery in the US.  Using simple wearables like a blood pressure monitor and sharing that data can improve outcomes dramatically for both the baby and the mother.

Disparities in accessing prenatal care between different socioeconomic groups has widened further during the pandemic. A whopping “six of the ten women reviewed who died during or after pregnancy from COVID-19 or its complications were from Black or minority ethnic groups”. Minority groups often have less access to quality medical care, housing, education, and food. More importantly, many minority women are not treated with the same quality of care and do not have advocates that can help make sure concerns are heard. Black women are three times more likely to die from pregnancy than white women. Bills such as the Affordable Care Act were passed to try to mandate certain health coverage requirements regardless of socioeconomic status, but the statistics on maternal mortality illustrate that the programs are not reaching the populations intended. Even after the Affordable Care Act was passed, the mortality rate continued to increase. The inelasticity of healthcare combined with current legislation, does not allow for healthcare costs or health coverage to change dramatically in the short-term.  This is where the use of digital health tools can have a huge impact on reducing cost and expanding access.  Digital health companies are developing devices that can monitor blood pressure, heart rate, oxygen saturation, sleep quality, and other vital signs for both the mother and baby. This data can help alert the patient and their doctor to serious conditions requiring intervention early on regardless of geographical location.

The pandemic has forced a change in the landscape of healthcare delivery.  Doctors’ and their patients are more comfortable than ever using these tools and technologies to provide and receive care.  The technologies are easy to use, incredibly effective, and largely inexpensive which makes them accessible to women all over. Perhaps the most important point being, data is objective.  It does not see ethnicity or socioeconomic status.  It is quite simply, the objective output of what is being monitored. Innovation is paramount in keeping a population healthy.  We are at a crossroads where digital health tools need to become part of the standard of care for pregnant women.  The use of wearables and other digital health tools during pregnancy expands access to prenatal care, decreases inequities, decreases costs, and improves clinical outcomes for both the mother and child.

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