(208) Statewide Utilization of Telemedicine for Prenatal Care Visits

Thursday, January 30, 2025

10:30 AM – 12:30 PM

Submitting Author and Presenting Author(s)

Harini Pennathur, BSE (she/her/hers)

Texas A&M University School of Engineering Medicine, United States

Coauthor(s)

Rachel A. Clark, BS (she/her/hers)

University of Michigan Medical School
Ann Arbor, Michigan, United States
Kenechukwu Odenigbo, BA

University of Michigan Medical School
Ann Arbor, Michigan, United States
SP

Shayla Parthasarathy, BS

University of Michigan Medical School
Ann Arbor, Michigan, United States
Michelle Moniz, MD, MSc (she/her/hers)

Associate Professor
University of Michigan
Ann Arbor, Michigan, United States
Lisa Kane Low, CNM, PhD (she/her/hers)

University of Michigan
Ann Arbor, Michigan, United States
Alex Peahl, MD, MSc (she/her/hers)

Michigan Medicine
Ann Arbor, Michigan, United States

Objective: To investigate statewide telemedicine practices for prenatal care, including barriers and facilitators of widespread adoption.

Study Design: Prenatal care providers were identified across Michigan through systematic web searches and snowball sampling. Semi-structured surveys assessed prenatal care practices, including use of telemedicine or not and modalities employed. We evaluated telemedicine utilization across clinic characteristics: clinic type, number of patients served, region, EHR type used, and insurance type limitations. Free-response questions about perceived barriers and facilitators of telemedicine implementation were summarized using qualitative content analysis. Funding support from Blue Cross Blue Shield of Michigan.

Results: In total, 19 clinics representing 8/10 state designated prosperity regions completed the survey, with an average of 408 (range 20-1700) patients per site. Telemedicine prenatal visits were offered at 13/19 (68.4%) clinics, of which, 5 offered video-only, 1 offered telephone-only, and 7 offered both. Fewer clinics that had restrictions on patient enrollment (e.g., do not accept patients with Medicaid) utilized telemedicine, but telemedicine availability did not differ across clinic types (Table 1). Key implementation barriers included provider willingness, patient comfort with/access to technology, scheduling, and lack of patient-provider connection through telemedicine. Facilitators were COVID-19 initiatives, time savings, existing telemedicine infrastructure, and training.

Conclusion: While stakeholders identified numerous advantages to the implementation of telemedicine in prenatal care, both infrastructure and interpersonal barriers exist. Realizing the potential improvements in accessibility, convenience, and efficiency for all patients requires thoughtful implementation across varied care settings.