4. Definition of Need
ďŹ Dispersed population
ďŹ Insufficient number of MFMâs,
geographic concentration
ďŹ Poor prenatal care access
ďŹ Not meeting HP2010 goals (preterm
birth, perinatal mortality)
6. Getting started
ďŹ Established Telehealth network helps
greatly
ďŹ Even with an established network, grant
support will facilitate early success
ďŹ Governorâs Productivity Investment Fund
ďŹ HRSA Office for Advancement of
Telehealth
7. Community Partners
ďŹ Commitment to patients with greatest
access limitations
ďŹ Health departments, community health
centers
ďŹ Skill level of local providers
ďŹ Communication, record-sharing, logistics
of delivery
10. Barriers to Success
ďŹ Lack of support from local obstetrical
community
ďŹ Miscommunication about location of
delivery
ďŹ Difficult patient population
ďŹ Insurance reimbursement for telehealth
11. Early Outcome Data
ďŹ Population: predominantly Hispanic,
most non-English speaking, most
uninsured
ďŹ Most common problem leading to MFM
referral: diabetes. Others include
hypertension, thyroid disease, multiple
gestation
12. Early Outcome Data
ďŹ Cohort prior to establishment of
telehealth MFM program:
ďŹ Mean GA first PNV: 17 weeks
ďŹ 25% entered care after 20 weeks
ďŹ Frequent missed visits
ďŹ First year of MFM telehealth program:
ďŹ Mean GA first visit 13 weeks
ďŹ None entered care after 20 weeks
ďŹ Only 3 missed visits among entire cohort
13. Early Outcome Data
ďŹ Other outcomes: too early /too few to
assess for differences
ďŹ Preterm birth
ďŹ Diabetes control
ďŹ Continuity â post-natal care and pediatric
care
ďŹ Patient satisfaction - HIGH!