Columbia University School of Nursing researchers found that utilizing patient EHRs to determine how far along a woman is in her pregnancy can support the automated delivery of content specifically targeted to their gestational age. The study found that Medicaid patients at the greatest risk of health disparities were able to get the information they needed to engage in better self-management during pregnancy.
In the qualitative, bilingual study, published in Generating Evidence & Methods to Improve Patient Outcomes (eGEMs), study author and Columbia Nursing assistant professor Adriana Arcia, PhD, analyzed how pregnant patients perceive or engage with maternity education delivered through their patient portals and personal health records using a research tool called Maternity Information Access Point (through Care Guide by Maternity Neighborhood). Eligible Medicaid participants were 18 or older, less than 35 weeks pregnant, and able to speak English or Spanish, and had a Wi-Fi-enabled device.
Arcia discovered that usage varied widely, and that popular features of the portal included push e-mails and reminders, while forgetting passwords and lack of technological experience were barriers to use. She notes that users desire easy-to-access content, but that this ease must be balanced against the need to safeguard protected health information.
Few participants felt that all of their information needs were met by their care provider, and mentioned that the educational platform helped to prevent the need to cross-check multiple unaccredited online sources of information to triangulate and establish credibility of the information. All but one said that knowing content was vetted through their care provider increased their confidence in its trustworthiness.
"Pregnant women in our study were very receptive to receiving information based on how far along they are in their pregnancy as recorded in the EHR," Arcia says. "Based on these results, we recommend exploring the use of other pieces of information from the EHR to push information to patients. For example, if the procedure codes in the EHR indicate that a patient just got stitches, they could automatically receive instructions on how to care for their wound."
In the study's focus group, participants said that they very much liked receiving pushed content weekly because they found the content to be relevant, easy to understand, and useful to them at their stage of pregnancy.
The paper, titled "Time to Push: Use of Gestational Age in the Electronic Health Record to Support Delivery of Relevant Prenatal Education Content," is published in a special issue of eGEMs highlighting electronic health data.
Source: Columbia University Medical Center