Preparing patients and providers for maternal telehealth
Preparation is key, both for providers who are new to maternal telehealth visits and for patients who are participating in telehealth care.
There are several ways your providers and staff can make sure telehealth visits are successful for you and your patients.
Health equity training
Encourage your providers and staff members to take online training in health equity. This will help your practice provide the best quality care to the patients who need it most. The populations most underserved when it comes to maternal health equity include:
- Black women and other patients of color
- LGBTQ+ patients
- Low-income patients
- Underinsured or uninsured patients
Book longer appointments for new patients and new parents. This extra time is critical for patients who may be new to telehealth or for patients with connectivity or privacy issues. The extra time will help them fully understand their maternal telehealth care plan and give them the opportunity to ask questions.
Have an emergency plan in place
Pregnancy and postpartum complications can sometimes be severe, even life-threatening for the parents and the baby. Set up an emergency plan with each telehealth patient and keep it in their file.
The emergency plan could include:
- The patient’s closest emergency contact and phone number
- The patient’s phone number and address in an easily accessible location if you need to call emergency medical personnel
- The closest hospital or medical facility that can handle a maternal health emergency
Be flexible with your provider and patient communication methods. Many pregnant families may not always have access to reliable and stable internet connections. This affects the very people who could benefit the most from health equity using maternal telehealth care. Other forms of non-video communication could include:
- Phone calls
- Chat through a healthcare portal
Keep up-to-date electronic health records (EHR) and read them. Pregnancy and maternal healthcare can be a sensitive issue for many patients. Give yourself time to read the patient’s EHR before each appointment.
This will help you treat your telehealth patients who are dealing with sensitive issues such as:
- Pregnancy from rape
- Potential or known birth defects
- Pregnancy or infant loss
- Planned adoption
- Fertility issues
Be prepared with follow up plans after the appointment. Let your patient know what will come next in their maternal telehealth care plan. Take time to answer questions and ensure they understand their next steps.
You will also need to consider what staffing you will need to handle follow up planning and instructions. Choose a nurse or staff member who will join the call to go over instructions and next steps. You may also want a member of the front desk staff to call and book the follow-up appointment.
While some follow up plans will need to be done in person, there are several ways you can continue to provide maternal telehealth care:
- Order lab or diagnostics tests. Set up a telehealth appointment to discuss the results
- Start or continue remote monitoring
- Refer your patient for other types of telehealth care, including lactation support or telebehavioral health
Preparation for your patients
Your patients will need some time to prepare for their maternal telehealth appointments whether it’s their first time or a follow up visit.
Before the telehealth appointment
There are several things you can do prior to your patient appointments to make sure they feel comfortable.
- Confirm your patient has access to the Internet. If not, share resources with them and/or consider other forms of telehealth communication
- Ask them to write down their concerns ahead of time
- Ask if they need assistive devices for the telehealth appointment
- Ask that they wear loose clothing in case you need to see parts of their body
- Make sure they receive and understand instructions on how to get online
During the telehealth appointment
There are also several ways to help your patient feel comfortable and confident during the appointment.
- Introduce yourself and ask if the patient has privacy and feels safe to speak
- Ask what questions or concerns they may have
- Make sure they understand test results or diagnoses that you are giving them
- Include the patient’s spouse, partner, or other family member in the discussion if the patient includes them in the video chat
- Follow up on remote monitoring results or concerns
- Provide information, if needed, i.e. the Women, Infants and Children (WIC) program or Medicaid
- Encourage patients to get a COVID-19 vaccine and educate them on the safety of the vaccine during and after pregnancy
After the telehealth appointment
Maternal telehealth care doesn’t end when your video chat is finished. Here are several ways to follow up with your patient and continue building the relationship.
- Send your patient instructions on what to do if they go into labor or experience pre-term bleeding or contractions
- Follow up with links or mail handouts on prenatal and postpartum local, state, and federal resources
- Schedule any testing or diagnostic imaging as soon as possible
- Send your patients for referrals to specialists, mental health professionals or substance abuse counselors, if needed
- Schedule any follow up maternal telehealth appointments
SpotlightU.S. Health Resources & Services (HRSA) Administration
HRSA’s Maternal and Child Health division has launched the Screening and Treatment for Maternal Depression and Related Behavioral Disorders (MDRBD) telehealth access program to support pregnant and postpartum patients in seven states. Training is also offered to health care providers to screen, assess, treat, and refer pregnant and postpartum patients for maternal behavioral health conditions, in a state’s specified regions, including in rural and underserved areas. The states included are Florida, Kansas, Louisiana, Montana, North Carolina, Rhode Island, and Vermont.