- A Medicaid-based mHealth study in Wyoming has found that pregnant women using a customized app are far more likely to consult with doctors during maternity – and they’re more likely to deliver healthy babies.
The study, conducted by the Wyoming Department of Public Health in 2014-15 using the WYhealth Due Date Plus app from Wildflower Health, found that app users were 76 percent more likely to schedule prenatal visits at least six months before delivery than those not using an app.
More importantly, pregnant women using the app were only 25 percent as likely to deliver a low-birth-weight baby as those women who didn’t use an app.
“Wyoming Medicaid saw fewer low-birth weight children in women who used the app than those in Medicaid not using the app, and we feel the app produced a 3:1 ROI based on cost avoidance,” James Bush, MD, FACP, Wyoming Medicaid’s medical director and the study’s co-author, said in a press release. “Cost savings and improved birth outcomes is a winning combination.”
The study, reported in Telemedicine and e-Health, focused on 85 pregnant women on Medicaid who used the app and another 5,158 pregnant non-app users with delivery outcome records in Wyoming Medicaid. More than 1,730 people reportedly downloaded the app during the study period, with registered Medicaid members using it an average of 6.4 times a month.
According to the study, In addition to short-term costs for delivery and perinatal care, negative pregnancy outcomes such as preterm birth and low birth weight carry important long-term consequences.
“Prematurity is a major driver of pediatric morbidity and disability, and it is associated with nearly 50 percent of all childhood neurodevelopmental disorders,” the study’s authors reported. “In a 2006 report, the Institute of Medicine (IOM) estimated an annual societal cost of $26.2 billion ($31.8 billion in 2015 dollars) associated with preterm birth in the United States, of which 2 percent stemmed from early intervention services, 4 percent from special education services, and 22 percent from lost household and labor market productivity.”
“Research aimed at improving U.S. birth outcomes has found that one of the most important determinants of birth outcomes is access to prenatal care,” the report notes. “Studies have found that even after adjusting for other differences like socioeconomic status and maternal age, infants born to mothers who receive no prenatal care weigh considerably less, on average, than those whose mothers receive prenatal care. In contrast, early prenatal care in the first trimester (the first 90 days) has been shown to have a significant positive effect on birth outcomes; for instance, a sample of white teenagers showed a 27 percent reduction in low-birth weight births when provided with early prenatal care.”
The app connects pregnant women to clinical information on common pregnancy symptoms and key health milestones. It also links users to Medicaid benefits information and community-based health and wellness resources such as the Women, Infants and Children (WIC) and Wyoming Quit Tobacco programs.
“This study demonstrates that mobile maternity applications can positively influence people’s decisions to attend early prenatal appointments and improve their connections to healthcare resources,” Dilek Barlow, MA, director of client services at San Francisco-based Wildflower Health and a co-author of the study, added in the press release. “Moreover, it shows that Medicaid populations can be highly engaged with digital tools that have the potential to greatly improve outreach and education in this population.”
The project adds to the growing literature making the case that mHealth apps can positively affect outcomes in population health programs. It also points to the value of a digital health program in a rural area like Wyoming, where physicians are scarce and patients are likely to face access issues.
“What I feel was a major factor in the success of Due Date Plus was that we were able to work with Wildflower Health to customize its links to connect users with providers and resources specific to their community,” Bush pointed out. “We are able to track how women are accessing these resources and programs.”