Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States.
Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, United States.
Stud Health Technol Inform. 2022 Jun 6;290:503-507. doi: 10.3233/SHTI220127.
Telehealth is an alternative care delivery model to in-person care. It uses electronic information and telecommunication technologies to provide remote clinical care to patients, especially those living in rural areas that lack sufficient access to health care services. Like other areas of care affected by the COVID-19 pandemic, the prevalence of telehealth has increased in prenatal care. This study reports on telehealth use in prenatal care at a large academic medical center in Middle Tennessee, USA. We examine the electronic health records of over 2500 women to characterize 1) the volume of prenatal visits participating in telehealth, 2) disparities in obstetric patients using telehealth, and 3) the impact of telehealth use on obstetric outcomes, including duration of intrapartum hospital stays, preterm birth, Cesarean rate, and newborn birthweight. Our results show that telehealth mainly was used in the second and third trimesters, especially for consulting services. In addition, we found that certain demographics correlated with lower telehealth utilization, including patients who were under 26 years old, were Black and/or Hispanic, were on a state-sponsored health insurance program, and those who lived in urban areas. Furthermore, no significant differences were found on preterm birth and Cesarean between the patients who used telehealth in their prenatal care and those who did not.
远程医疗是一种替代面对面护理的医疗服务模式。它使用电子信息和远程通信技术为患者提供远程临床护理，特别是那些居住在农村地区、无法获得足够医疗服务的患者。和其他受 COVID-19 大流行影响的医疗领域一样，远程医疗在产前护理中的应用也有所增加。本研究报告了美国田纳西州中部一家大型学术医疗中心的产前护理中远程医疗的使用情况。我们研究了超过 2500 名女性的电子健康记录，以描述：1）参与远程医疗的产前就诊量；2）使用远程医疗的产科患者的差异；3）远程医疗使用对产科结局的影响，包括分娩期间住院时间、早产、剖宫产率和新生儿出生体重。研究结果表明，远程医疗主要在第二和第三个孕期使用，特别是咨询服务。此外，我们发现某些人口统计学特征与远程医疗利用率较低相关，包括 26 岁以下、非裔和/或西班牙裔、参加州政府资助的医疗保险计划以及居住在城市地区的患者。此外，在使用远程医疗进行产前护理的患者和未使用远程医疗的患者之间，早产和剖宫产的发生率没有显著差异。
