Telehealth interventions associated with improved obstetric outcomes

Telehealth interventions are associated with improved obstetric outcomes, according to a review published from physician-researchers at the George Washington University. The article, published in the journal Obstetrics and Gynecology, presents a systematic review of studies on telehealth interventions that report health outcomes in selected areas in low-risk obstetrics, family planning, and gynecologic conditions.

In recent years, health care has seen an increase in patient use of supportive technologies, such as mobile phone apps, wearable devices, short message service or text messaging, multimedia messaging services, and live-audio visual communication. In 2014, there were nearly 2,000 obstetric mobile phone apps available, according to the article. However, the development of evidence-based practices for those technologies lags behind the use of the technology by patients and providers.

"Establishing evidence-based practices in this emerging dimension of health care delivery is important to mitigate potential health risks and costs that could be associated with rapid adoption of new technologies that have not been adequately studied," said Nathaniel DeNicola, MD, assistant professor of obstetrics and gynecology at the GW School of Medicine and Health Sciences and first author on the review. "It would also be helpful for overcoming barriers to adoption of clearly beneficial technologic advances."

Through the team's review of the primary literature, a couple of themes emerged supporting telehealth interventions in obstetrics and gynecology. One was that text messaging may be helpful for reinforcing certain health behaviors, such as smoking cessation during pregnancy, consistency in breastfeeding, and adherence to contraception. The second theme the authors identified was the role of remote monitoring and virtual visits in settings where there are barriers to facility-based care.

"This review highlights the gap in knowledge of telehealth-mediated interventions in women's health care," DeNicola said. "While patients and many providers are excited about these tools, we still know very little about their effectiveness."

The authors suggest that more evidence is needed to help clinicians determine how they can integrate telehealth into practice in ways that clearly improve patient care.