Health officials plan to expand a pilot program that has improved maternal health outcomes for pregnant women in Florida.
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Dr. Kenneth Scheppke, deputy secretary for health at the Florida Department of Health (DOH), discussed the program during a Senate Committee on Health Policy meeting last week. The telehealth minority maternity care pilot program that has been operating in Duval and Orange counties over the past year.
There were 51,454 cases of severe maternal morbidity (the presence of a complication during a delivery hospitalization) among delivery hospitalizations in Florida from 2013 to 2022, Scheppke said. Out of a total of almost 2.2 million live births for the 10-year period ending in 2021, there were 416 pregnancy-related deaths.
“The leading cause of pregnancy-related deaths during this period were bacterial infections, hemorrhage, and hypertensive disorders,” Scheppke said. “There are several modifiable risk factors both for morbidity and mortality in pregnancy. High blood pressure, elevated sugar, and unhealthy weight are all well-known risks that can lead to poor outcomes in pregnancy.”
The pilot program changes the legacy treatment model of patients seeking care to a model in which care is brought to the patient in their homes, Scheppke said.
“This model, using technology and partnering with various wraparound services, expands the healthcare team’s capacity to provide care for pregnant and postpartum women, and expands the ability to detect and mitigate these risk factors that lead to poor outcomes.”— Scheppke
Program services include screening for and treating pregnancy-related complications, referrals to meet individual needs such as home-visiting services, education on pregnancy and child births, and remote patient-monitoring tools.
“The patient can check her sugar at home, and that is immediately uploaded through the internet to a healthcare team so they can see real-time data,” Scheppke said.
The program’s implementation began on July 1st, 2022, through contracts with Orlando Health in Orange County and Agape Family Health in Duval County. The hospitals provided 2,533 patients with access to maternal care who might not otherwise have had access, Scheppke said.
“The priority populations were ethnic and minority populations, health professional shortage areas, areas with significant ethnic and racial disparities, medically-underserved populations, and indigenous populations,” he said. “Both pilot sites successfully identified chronic, underlying health conditions that put pregnant women at risk.”
An evaluation of the program found that there have not been any reported deaths in this patient population to date. At the Duval County site, 10 women were admitted to the hospital for preeclampsia (a complication of high blood pressure) detected through the program’s remote monitoring system, Scheppke said. Elevated blood symptoms and irregular heartbeats were also detected through the monitoring system.
“At the Orange County site, 52 women were sent to the emergency room for potential pregnancy-related complications. These interventions were all done early in the course of disease, which allowed us to mitigate the negative effects these conditions would have because they were found much sooner, before patients would have symptoms in many cases.”— Scheppke
DOH received over $12 million in general revenue funding for fiscal year 2023-24 to continue the program’s work in Duval and Orange counties and support its expansion to 18 additional counties, Scheppke said.
“The expansion counties were chosen using data-driven decisions to determine the areas with the highest number of women experiencing severe maternal morbidity,” he said. “The department is currently in the process of contracting with local providers to enact this expansion. For our next steps, we’re looking to expand the data system so we can capture additional outcome measures.”
Sen. Gayle Harrell (R-Suart) asked if DOH could provide the legislature with information on how much it would cost per patient to expand the program statewide.
“We’ll follow up on that,” Scheppke said. “One thing the department does, as we enroll these women into the program, is those that are Medicaid-eligible would be able to enroll on to the Medicaid program as well, which helps to fray the cost locally.”