The American College of Obstetricians and Gynecologists (ACOG) recommending OB practices individualize care delivery for their patients in their new clinical consensus.
The idea of customizing the care model is likely something you’ve considered as you’ve juggled a full docket of pregnant patients. Some low-risk patients don’t need as many in-person check-ins, especially when reimbursable technology like telehealth is available.
Meanwhile, high-risk pregnancies may benefit from more than the average number of clinical touchpoints, especially with gestational diabetes (GDM). This new recommendation to individualize visit cadence may improve how you approach patient care in your clinic.
Below, we’ve summarized the new clinical consensus from ACOG and have added our insights on how tailoring care delivery may impact those with GDM.
Why Change Now?
Initially established in the 1930s, the formalized model of 12-14 prenatal visits has changed little, despite advancements in technology and the recognition of social barriers to optimal care. Research has demonstrated that the traditional visit model is outdated and lacking in ensuring adequate care.
Most initial visits don’t occur until the tail-end of the first trimester. Even then, almost a quarter of patients miss that critical visit. Furthermore, only half of pregnant patients attend the recommended visits in the suggested timeline.
Additionally, health equity remains an issue. Race, socioeconomic status, and geography all impact access to prenatal care. There are inequities in maternal outcomes that require a hard look at how prenatal care is tailored for marginalized demographic groups.
The pandemic quickly updated care delivery to include targeted visits, the incorporation of telehealth, and remote monitoring. As a result, ACOG and the University of Michigan assembled a committee of experts to provide recommendations for updating the prenatal care delivery model.
What Are the Consensus Recommendations?
The committee voted on key points based on extensive literature reviews to include in their consensus. Here’s what they recommended to obstetrician-gynecologists (OB-GYNs):
- Conduct a needs assessment to determine medical and social determinants of health before 10 weeks of gestation or at the first visit.
- Involve your patient in care plan development with shared decision-making
- Coordinate care and assistance from community resources and the health system to meet social needs.
- Adjust prenatal care delivery to provide greater access for your pregnant patients.
- Customize visit and monitoring frequency as needed according to the medical and social needs of your patient.
- Provide telehealth or alternative visit options that support the completion of evidence-based services.
- Tailor patient monitoring options for routine pregnancy indicators.
Overall, the message is to exchange the cookie-cutter model of a prescribed number of visits for flexibility and customization. OB-GYNs can utilize technology and clinical judgment to meet the patients’ medical and social needs. Individualizing care can have a positive impact on antenatal outcomes.
How Will the New Model Impact Prenatal Care?
The goal of the clinical consensus is to improve critical access to prenatal care for all, especially in underserved demographic regions. Modernizing and tailoring care delivery practices will better meet health care needs.
Not only will optimizing one of the most common preventive services in the US improve maternal and child health, but the shift to an individualized approach also addresses social determinants of health.
How will this look in your clinic? Maybe it means fewer, but longer, more meaningful in-person visits. Perhaps you can consider telehealth visits for those who are at low risk, or with transportation or scheduling issues. Implementing remote monitoring and digital data reviews can expedite services in a convenient way for both patients and providers.
How Tailoring Care Delivery Impacts Diabetes in Pregnancy
Patients with GDM or preexisting diabetes often require more frequent visits, especially toward the end of pregnancy. However, it’s never been easier to have more individualized diabetes care.
Continuous glucose monitoring provides real-time data that can be easily shared with the necessary clinic staff to make timely treatment decisions. Instead of waiting until the next in-person visit to adjust treatment, adjustments to care are immediate and individualized.
CMS and other governing bodies are encouraging maternal remote patient monitoring (RPM), particularly for high-risk pregnancies. RPM visits can improve access to care and provide flexibility for patients, and are covered with new billable CPT codes. Many offices are not yet implementing RPM for managing high-risk pregnancies. For more information on setting up your CPT codes, check out our billing guide.
LilyLink provides technology and services to help your practice implement connected, digital care for gestational diabetes patients. We have qualified diabetes educators who can help support your clinic with data reviews, patient education, and medical nutrition therapy.
Contact us today for a demo.