Telehealth For Equitable Obstetric Care: Addressing Gaps For Patients, Providers, and Payers

Abstract

On June 2022, President Biden and Vice President Harris released their blueprint for addressing the maternal health crisis. They stated their “vision for the future is that the United States will be considered the best country in the world to have a baby.” Currently, it is one of the worst among industrialized countries despite the U.S. spending nearly double the average amount on healthcare per capita. The U.S. is amidst a maternal mortality crisis, particularly for Black and American Indian/Alaska Native pregnant people, with more than 80% of the deaths preventable. Telehealth in obstetrics has the potential to reach pregnant people who are not currently being served by the medical system and to improve rates of severe maternal morbidity and mortality; however, more research is needed to understand and monitor its equity, costs, and optimal usage. Extant research shows that telehealth can produce a small positive effect on certain obstetric health outcomes, but pregnant patients’ demographics rarely stratify these research findings. To prevent the perpetuation of existing health inequities, gaps in obstetric telehealth research will need to be addressed. Key knowledge gaps for researchers and policymakers include outcomes, access, satisfaction by patients and providers, potential time savings for patients, and health system cost savings. Implementing equitable obstetric coverage of telehealth services requires clarity from private and public payers for inter-state provisions of care, liability and risk, and service and payment parity.