The Omaha Program uses HIE technology to improve postpartum care for minority parents and children

CyncHealth, Collective Medical and Innsena are being recognized by the Department of Health and Human Services’ Racial Equity in the Postpartum Care Challenge, including a $40,000 federal grant, for the care program. after their birth in Omaha.

Pregnancy-related mortality is three to four times higher in minorities than in white women, even among those with college degrees. This program improves postpartum care for high-risk Black and Indigenous parents and children enrolled in the Children’s Health Insurance Program and Medicaid, while significantly reducing mortality in mothers and infants.

Of the 25 HHS-recognized winners, this program is the only one to use health information exchange technology to improve personal care at the community level.

PROBLEM

Jaime Bland, CEO of CyncHealth, HIE said: “Support throughout pregnancy and postpartum is critical to creating lifelong health and wellbeing, physically and mentally. mother and infant. “In the days, weeks, and months after giving birth, women are at a critical moment in need of care as they experience physical, social, and psychological changes.

She added: “Thousands of women experience unintended outcomes in labor and delivery, with serious short- or long-term consequences for their health.

Postpartum care visits in the weeks after giving birth are essential, because this is when a woman is most at risk for complications that can be quite serious, even fatal. Pregnancy-related mortality rates for black or African-American women and Native American and Alaska Native women are two to three times higher than those for non-Americans. Caucasian, Hispanic and Asian/Pacific Islander.

Despite the wide range of postpartum care available, women continue to face barriers to getting that care.

“In Nebraska, 19% of women said they sometimes feel frustrated, depressed or hopeless after giving birth, and more than 7% said they feel this way often,” says Bland. “National statistics say one in four women experience postpartum depression, but only one in eight women ask for help with that depression.

“Notably, Nebraska ranks 19th nationally in terms of maternal morbidity and faces significant racial disparities in maternal morbidity and mortality,” she continued. “In Douglas County, the black infant mortality rate is 14.5 per 1,000 births, more than double the death rate for white and Hispanic infants.”

SUGGESTIONS

CyncHealth is the designated health information exchange for Nebraska and Iowa and serves more than six million people in the region.

As a trusted neutral tool that provides health information, CyncHealth is building a health data widget, where health data tracks a person wherever they seek care and Alerts emergency department visits to primary care providers and builds a vertical health profile that helps providers better understand each case. point of care that the patient is receiving.

“This kind of comprehensive patient data offers a unique solution for bridging the gap in maternal health needs,” explains Bland. “When timely alerts, medication history, encounter information, care plans and other essential information are automatically shared, transitions of care lead to a better experience for everyone. , outcomes improve, redundancies are reduced and – most importantly – mothers and babies are less likely to fall into the loopholes of the health care system and more likely to get the care they need and deserve.”

CyncHealth partnered with two other organizations — Innsena, a health technology consulting company, and Collective Medical, a PointClickCare company that creates and delivers point-of-care notifications — to design technology that helps service providers The health care and care team identifies mothers and infants at risk to enable improved care coordination and information before, during, and after birth.

These notifications alert healthcare providers in real time and at the point of care. Such notices inform providers of relevant recent diagnoses, conditions, and health events to support clinical decision-making.

“This leads to earlier and timely intervention, reducing dangerous complications and total health care costs,” says Bland. “Innsena is a consultant to both companies, ensuring successful program implementation and supporting policy changes, sometimes needed.

“Using CyncHealth and their technology partners to bridge the gap in maternal health also provides an opportunity to measure the success of different interventions,” she notes. “Leveraging technologies and partnerships that facilitate the delivery of key indicators such as primary preventive care measures, coordination to transform care, and avoidable complications, provides important insight into the effectiveness of programs, initiatives and interventions.”

She added, showing the program’s success with tangible numbers increases the likelihood of sustaining and increasing the program budget through grants, donations, other awards or internal sources to ensure long-term success in reducing disparities in maternal and newborn health.

MEET CHALLENGES ONLY

Maternal health programs support health outcomes throughout pregnancy and postpartum by helping health care teams identify mothers and infants at risk so that care can be coordinated. improved and well-informed care before, during, and after birth, especially Blacks, African Americans, American Indians, and Alaskans Indigenous parents at high risk for Medicaid and Children’s Health Insurance Program.

“These populations were chosen because they have a significantly higher risk of maternal morbidity and mortality compared with other races,” explains Bland. “Strikingly, this racial disparity occurs regardless of education level or socioeconomic status. And maternal health is an important issue: About two out of every three deaths involve pregnancy is considered preventable.

“The program helps identify pregnant women with high-risk conditions such as diabetes, hypertension, depression and/or anxiety, substance use disorders, and infant exposure to substances addiction, and provides key data points that inform evidence-based approaches to increasing access to and participation in health exams and quality of care throughout pregnancy and after giving birth,” she continued.

The aggregation leverages ICD-10 diagnostic codes and ontology (value sets) drawn from Hospitalization, Discharge, Data Transfer and, potentially, patient dashboard files from OB/GYN, PCP, and FQHC clinics, and generate high-risk pregnancy and postpartum trigger flags with real-time alerts, groups, and reports – depending on workflow and field use by managed care organizations, hospitals, clinics, and other care facilities.

Flags may also be added through a patient’s eligibility record by a managed care organization or clinic that includes Medicaid or CHIP status. CyncHealth worked with Collective Medical to expand the program to include race/ethnicity reporting so that program participants can apply filters and identify women as Black or American African Americans, Indian Americans, and Alaska Natives.

“Using critical systemic, clinical and community strategies to address gaps in care for Blacks, African Americans, Indian Americans, and Alaska Natives,” says Bland. location, outcomes and conditions typically associated with a lack of health and supportive services would be prevented.”

“Additionally, Collective technology users can add patient care-specific insights to show important information to the women’s care team,” she continued. “Finally, Collective also collects the contact information of care team members to improve care coordination between different providers.”

RESULT

The Omaha Program was recently recognized by the U.S. Department of Health and Human Services as the top 25 Phase I winners of the HHS Racial Equity Challenge in the Postpartum Care Challenge. The program is also planning to enroll in Phase II of the challenge, which will measure results and success.

The Maternal Health Program through CyncHealth enables federally qualified hospitals, clinics, medical centers, PCP, OBGYN, and underlying substance use disorder clinics and facilities Drug Supportive Treatment identifies mothers and infants in need of care and facilitates and supports their comprehensive coordination of care throughout pregnancy and postpartum.

“Collective Medical has run variations of this program in both Washington and Idaho, where they’ve been wildly successful,” Bland said. “In Washington, for example, an analysis showed that pregnant patients participating in the program experienced a 54.6% reduction in ED use. The Omaha program is still in its early stages and more numbers are expected. to provide good metrics.”

TIPS FOR OTHER PEOPLE

“Move to a value-driven model, invest in technology and integrate medical records, and you’ll see tremendous success both in terms of internal efficiency and patient outcomes,” advises Bland.

Bland emphasized that:

• SDOH problem. The area where addressing social determinants of health is extremely important, she said.

• Active technology is here. She noted that the advanced data infrastructure that exists in healthcare today is addressing SDOH disparities through a value-based care-driven business model.

• Other states could repeat this success. As noted, the Omaha program is happy to share best practices and methods.

“SDOH are social and economic conditions that influence individual and group differences in health status, and they can be a major cause of health inequalities when populations are not access to the same resources,” says Bland.

“This field was mostly unexplored a generation ago,” she continued. “Recognizing the potential for impact, the government has allocated more than $650 million by 2022 to support various Medicaid pilot programs that address SDOH issues.”

Omaha’s work is specifically in maternal health, an area that the US Department of Health and Human Services announced a $350 million prize to address. Many states are using these funds to expand home visit services to families most in need, increase access to doulas, address health outcomes disparities, and improve reporting. maternal and neonatal health data.

“If you’re not one of those states, learn about those of us who have a work agenda and get to work and succeed in your own area,” she concludes. .

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