As state laws and Medicare/Medicaid reimbursement codes expand to allow more uses of telemedicine, one of the growing areas of telemedicine is womens reproductive care. Whether addressing obstetrics and gynecology (OB/GYN), fertility, pregnancy, prenatal care, post-partum delivery, cancer, or training rural physicians to improve care, womens healthcare is seeing an upsurge in telemedicine. Privacy, convenience, and availability all play a part in the growing popularity of reproductive health via telemedicine.
Not Just for Fevers and Sore Throats
The use of telemedicine in specialty modalities is growing exponentially, but many people may have a limited understanding of telehealths applicability in specialties. Telehealth app companies tout the convenience of having a doctor at your fingertips, but few talk about the specialty care that can be delivered through a mobile device, potentially leaving many to assume telemedicine works best for more common medical issues such as fevers and sore throats.
While OB/GYN does require in-office exams, the use case scenarios for OB/GYN telemedicine are in providing post-operative care, managing medications, discussing lab results and well woman exam results, and monitoring treatment plans. Conditions such as post-partum depression and gestational diabetes can be monitored through telemedicine, and save women time and money while receiving essential care. One program at the Medical University of South Carolinas Center for Telehealth uses telemedicine to treat pregnant women who are addicted to opioids, in which psychiatrist Dr. Connie Guille connects to the patients in their OB/GYN offices, monitors their condition, and prescribes medication to help the patients with their addiction.
In Arizona, a local healthcare company provides mothers-to-be and new mothers up to 12 months post-partum access to a telehealth app in which women can talk to nurses, nutritionists, and lactation consultants 24/7. Pregnant women can receive guidance on a variety of issues ranging from prenatal diet to infant health issues such as colic. The program, considered to be a pilot program, is being assessed for its success in providing these women the care they need.
Another growing use of telemedicine in womens health is in genetic counseling. Whether a woman has a family history of cancer and may have the BRCA1 or BRCA2 gene mutation, or if a woman has been diagnosed with breast or ovarian cancer, genetic counseling is viewed as being vital in assessing and treating cancer patients. In 2017, Dr. Jubilee Brown presented the growth of newly diagnosed ovarian cancer patients receiving genetic counseling over a three year period, which grew from 40 percent in 2013 top 58 percent in 2014 to 96 percent in 2015.
Training Rural/Remotely Located Providers
Its not unheard of that health organizations and institutions are using telemedicine to simultaneously train physicians and provide a diagnosis and treatment to a case. Inspecific case in Utah, Dr. Brett Einerson developed a program called the Obstetric Hemorrhage Collaborative, in which he invited all Utah hospitals to participate. The program was six months long and included two in-person training meetings and teleconferences twice a month with expert mentors. The in-person sessions focused on hands-on training and strategies for treating obstetric hemorrhage, and the mentoring sessions were led by regional and national experts in obstetric hemorrhage. Surveys were conducted pre- and post-training to monitor the participation and rate of improvement in care. Of all the obstetric hospitals in Utah, 15 (34 percent) participated in the program. All participants reported the teleconferencing sessions were helpful, and 14 of the 15 reported being very satisfied with the collaborative. A specific outcome of the training was the need for hospitals to track the rate of hemorrhage after delivery, a vital tool in determining the effectiveness of the tools used to treat and prevent obstetric hemorrhage.
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