An interactive digital platform that delivers tools and resources to participants to guide them along their perinatal journey, reducing hypertension-related mortality and improving overall health and wellness.
Case Study
Mom’s Heart Matters
PROGRAM DESCRIPTION:
An interactive digital platform that delivers tools and resources to participants to guide them along their perinatal journey, reducing hypertension-related mortality and improving overall health and wellness. Using Bluetooth-enabled blood pressure cuffs, the clinical care team is able to remotely monitor patient status 24/7 via real-time readings. Sophisticated logic and business rules identify hi-risk readings and escalate concerns to avoid potential adverse events. The evidence-based program creates a safety net for high-risk moms that seamlessly integrates physical, behavioral, and social drivers of health with the power of technology and behavioral science.
The program is accessible to perinatal women in high-risk, underserved populations in southern Georgia.
PILOT PROGRAM SITE:
PROGRAM OBJECTIVES:
PROGRAM OUTCOMES:
Of the participants opted into remote blood pressure monitoring, 23% had escalations of which 100% were successfully addressed with real-time interventions
h Reduce hypertension related maternal mortality
• Earlier intervention to reduce SUD/OUD related adverse events
The most common causes for escalations: SUD, Mental Health, SDoH, Breastfeeding
• Reduce SDoH related disparities, including blood pressure monitoring, breastfeeding initiation and continuation rates, maternal functioning and mental health
100% felt they were being “actively engaged” through this platform
h Increase active engagement with target audience
100% were “extremely satisfied” with the platform’s engagement tools, content, and interactions
h Improve patient and member experience
95% retention rate among all enrolled participants
100% of participants would recommend the program
Program Components:
Care Communications: Upon enrollment, participants receive text messages to support their postpartum journey both physically and emotionally, with some including links to tailored resources. Topics include access to care, breastfeeding, cardiovascular health, medication/ device management, mental and emotional coping strategies, parenting and substance use. Care Companion: This cloud-based learning management system (LMS) provides vetted educational content that is personalized by participants’ self-expressed priorities and interests, structured into easy-to-follow sections to promote independent education, learning and self- care management. GoMo Chat: Much like a typical text conversation, GoMo Chat allows (secure) live messaging between participants and their care team, enabling in-the-moment, on demand conversations. Remote Patient Monitoring (RPM): Utilizing Bluetooth-enabled blood pressure cuffs, the program empowers moms to be actively involved in their care management. Real time data collection enables clinical care teams to monitor patients anywhere, at any time and to act in the moment to avoid potential adverse events. Secure Data Collection and Reporting: Engagement and experience data is collected and analyzed, then reported back to providers for ongoing quality, clinical delivery and service improvement.
“This is a wonderful program, and it really has made a huge difference. Even if you can save one mom, it is priceless. Our patient can now watch her child graduate high school you can't put a price on that.”
Heather Daniels, R.N./B.S.N., Perinatal Services Director at Liberty Regional Medical Center
PARTNERS AND ADDITIONAL PROGRAM ADOPTERS:
gomohealth.com
info@gomohealth.com
Patient Case Report
TREATMENT PLAN:
PATIENT: African American female and first time mom
+ Mom’s Heart Matters
engagement platform with Bluetooth-enabled blood pressure cuff for real-time patient monitoring
AGE: 22
DIAGNOSIS: Postpartum Hypertension
+ Blood pressure medicine
ASSESSMENT:
+ Care team received escalated blood pressure readings forty eight hours post-discharge
+ Contacted patient to come in to avoid potential adverse event
+ Upon admission patient was in hypertensive crisis
+ Care team was able to stabilize her within the hospital setting and re-titrated her medicine because of the in-the-moment escalation and immediacy of intervention
MOM’S HEART MATTERS PARTICIPANT EXPERIENCE:
1. Enrolled in program by clinical care team; completes initial survey that collects health priorities
2. Customized content is delivered directly to patient
3. Blood pressure cuff readings automatically delivered to provider and escalated as appropriate
4. Based on feedback collected in ongoing surveying, the program dynamically pivots to provide support for each woman’s changing needs
5. Patient can “chat” with their clinical care team in a secure environment
6. Patient can access the web-based program via any web enabled device – including mobile phone (most common), desktop and iPad (no app to download)
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