Virtual Visits

Pflugeisen, Bethann M.; McCarren, Christi; Poore, Stephen; Carlile, Malinda; Schroeder, Richard

doi:10.1097/nmc.0000000000000199

Cited by 80 publications

(83 citation statements)

References 18 publications

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“…Three women were recalled to the hospital due to suspicious f-ECG, of which in 2 cases caesarean section was indicated. A Virtual Obstetric Care program with normal visits combined with teleconferencing visits for low-risk pregnancy showed no increased risks in health outcomes besides an increase in preeclampsia diagnosis [ 74 ]. Another demonstration project describes a promising system of a wirelessly enabled maternal-fetal monitoring system MiBebe , used for the improvement of perinatal care in rural regions in Mexico.…”

Section: Resultsmentioning

confidence: 99%

eHealth as the Next-Generation Perinatal Care: An Overview of the Literature

Heuvel¹,

Groenhof²,

Veerbeek³

et al. 2018

J Med Internet Res

255

187

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BackgroundUnrestricted by time and place, electronic health (eHealth) provides solutions for patient empowerment and value-based health care. Women in the reproductive age are particularly frequent users of internet, social media, and smartphone apps. Therefore, the pregnant patient seems to be a prime candidate for eHealth-supported health care with telemedicine for fetal and maternal conditions.ObjectiveThis study aims to review the current literature on eHealth developments in pregnancy to assess this new generation of perinatal care.MethodsWe conducted a systematic literature search of studies on eHealth technology in perinatal care in PubMed and EMBASE in June 2017. Studies reporting the use of eHealth during prenatal, perinatal, and postnatal care were included. Given the heterogeneity in study methods, used technologies, and outcome measurements, results were analyzed and presented in a narrative overview of the literature.ResultsThe literature search provided 71 studies of interest. These studies were categorized in 6 domains: information and eHealth use, lifestyle (gestational weight gain, exercise, and smoking cessation), gestational diabetes, mental health, low- and middle-income countries, and telemonitoring and teleconsulting. Most studies in gestational diabetes and mental health show that eHealth applications are good alternatives to standard practice. Examples are interactive blood glucose management with remote care using smartphones, telephone screening for postnatal depression, and Web-based cognitive behavioral therapy. Apps and exercise programs show a direction toward less gestational weight gain, increase in step count, and increase in smoking abstinence. Multiple studies describe novel systems to enable home fetal monitoring with cardiotocography and uterine activity. However, only few studies assess outcomes in terms of fetal monitoring safety and efficacy in high-risk pregnancy. Patients and clinicians report good overall satisfaction with new strategies that enable the shift from hospital-centered to patient-centered care.ConclusionsThis review showed that eHealth interventions have a very broad, multilevel field of application focused on perinatal care in all its aspects. Most of the reviewed 71 articles were published after 2013, suggesting this novel type of care is an important topic of clinical and scientific relevance. Despite the promising preliminary results as presented, we accentuate the need for evidence for health outcomes, patient satisfaction, and the impact on costs of the possibilities of eHealth interventions in perinatal care. In general, the combination of increased patient empowerment and home pregnancy care could lead to more satisfaction and efficiency. Despite the challenges of privacy, liability, and costs, eHealth is very likely to disperse globally in the next decade, and it has the potential to deliver a revolution in perinatal care.

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Section: Resultsmentioning

confidence: 99%

eHealth as the Next-Generation Perinatal Care: An Overview of the Literature

Heuvel¹,

Groenhof²,

Veerbeek³

et al. 2018

J Med Internet Res

255

187

View full text Add to dashboard Cite

show abstract

“…13 The potential benefits of virtual visits in the setting of the COVID-19 pandemic may further support provision of telehealth services despite well characterized legal, regulatory, liability, and reimbursement hurdles. 13 Prior research has demonstrated comparable outcomes with prenatal telehealth visits, 14 with patients demonstrating satisfaction with virtual visits. 15 A recent systematic review of telehealth interventions in obstetrics and gynecology evaluated 47 studies of which 19 pertained to low-risk obstetrics and 13 pertained to high-risk obstetrics.…”

Section: Discussionmentioning

confidence: 97%

Telehealth for High-Risk Pregnancies in the Setting of the COVID-19 Pandemic

et al. 2020

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As New York City became an international epicenter of the novel coronavirus disease 2020 (COVID-19) pandemic, telehealth was rapidly integrated into prenatal care at Columbia University Irving Medical Center, an academic hospital system in Manhattan. Goals of implementation were to consolidate in-person prenatal screening, surveillance, and examinations into fewer in-person visits while maintaining patient access to ongoing antenatal care and subspecialty consultations via telehealth virtual visits. The rationale for this change was to minimize patient travel and thus risk for COVID-19 exposure. Because a large portion of obstetric patients had underlying medical or fetal conditions placing them at increased risk for adverse outcomes, prenatal care telehealth regimens were tailored for increased surveillance and/or counseling. Based on the incorporation of telehealth into prenatal care for high-risk patients, specific recommendations are made for the following conditions, clinical scenarios, and services: (1) hypertensive disorders of pregnancy including preeclampsia, gestational hypertension, and chronic hypertension; (2) pregestational and gestational diabetes mellitus; (3) maternal cardiovascular disease; (4) maternal neurologic conditions; (5) history of preterm birth and poor obstetrical history including prior stillbirth; (6) fetal conditions such as intrauterine growth restriction, congenital anomalies, and multiple gestations including monochorionic placentation; (7) genetic counseling; (8) mental health services; (9) obstetric anesthesia consultations; and (10) postpartum care. While telehealth virtual visits do not fully replace in-person encounters during prenatal

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“…Antenatal care is important to monitor mother and baby by doing regular check monthly (Widiasih, Ermi, & Setyawati, 2018). Furthermore, to improve antenatal care, Pflugeisen et al, (2016) developed a new model or program of antenatal care, namely a virtual visit for low-risk pregnant women who interspersed doctor visits directly with nurse practitioner visits through video conferencing. This program may be very relevant to the practice of serving pregnant women in the countryside or pregnant women who live far from their providers.…”

Section: Technology In the Form Of Tools Or Devicesmentioning

confidence: 99%

Health Technologies for Detecting High Risk Conditions in Pregnancy: A Systematic Review

Madiuw

Widiasih

Napisah

2019

JNC

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In this technological era, various health technology including media, instruments and tools are created in area maternal and babies’ health. However, comprehensive information about these technology products are limited. This literature review aimed to find health technology in area maternal and baby especially in detecting high risk conditions in pregnancy. Method, this is a systematic review, the articles were searched from two databases including PubMed and CINAHL using several keywords. The keywords were high risk, pregnant women and technology OR instrument OR tools. Inclusion criteria are primary research, English language, and publications in the last 5 years. After the critical appraisal, a total of 16 articles included in the analysis. Result: The literature related of technology divided into two criteria which are the questionnaire development and health tools or devices. None of technology came from Indonesia. The entire technology showed effectiveness in detecting risks, and interventions to improve prenatal care. The target user for health tools mostly health professionals. Conclusion: various health technologies in area maternal in baby health are identified, however the majority of them provided from health professionals. Technology development is needed specifically, in the form of simple and practical tools or devices to assess foetal health with target user is pregnant women with high risk pregnancy.

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Virtual Visits

Cited by 80 publications

References 18 publications

eHealth as the Next-Generation Perinatal Care: An Overview of the Literature

eHealth as the Next-Generation Perinatal Care: An Overview of the Literature

Telehealth for High-Risk Pregnancies in the Setting of the COVID-19 Pandemic

Health Technologies for Detecting High Risk Conditions in Pregnancy: A Systematic Review

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