Data collected by the National Center for Health Statistics shows that in 2018, about 315,000 live births occurred each month in the United States.
Topping that list was August, with 345,000 live births in that month alone. Regardless of when a baby is born, carrying and bringing a new person into the world can be an exciting and joyful time. Childbirth can also come with a good deal of anxiety. In fact, in rural America, as more and more hospitals close and critical maternal care services disappear, that anxiety can build up.
In addition to mounting socioeconomic disadvantages, rural hospitals often close or cut services because of financial shortfalls. Maggie Elehwany, the Vice President of Government Affairs and Policy at the National Rural Health Association says one of the first places many rural hospitals look to cut costs is the obstetrics (OB) department.
“Obstetrics departments are definitely a red flag when a hospital is financially hurting,” says Elehwany. “Obstetrics is such an expensive department to maintain . . . It's often something that we see cut, but it's becoming absolutely detrimental to so many women across the country.”
From 2004 to 2014 the number of U.S. rural counties providing OB services dropped from 54 percent to 45 percent. An article from the Scientific American offers a more localized perspective stating that in 1980, obstetrics services could be found in 45 of Alabama’s 54 rural counties. In 2017, at the time of the article’s publication, only 16 of those rural counties still provided OB services.
In Grand Marais, Minnesota, 1300 miles north of Alabama, a family was forced to drive four hours in a blizzard to reach their birthing hospital. Why? Their local healthcare facility stopped delivering babies four years ago. Luckily, for that couple, after a 46-hour delivery they welcomed a healthy baby girl into their lives. Some however, are not so fortunate.
A study from the Journal of American Medicine reveals a link between the “loss of hospital-based obstetrics care in rural counties not adjacent to urban areas” and an increase in out-of-hospital and preterm births. In other words, it could be argued that labors not under dedicated perinatal care may come with added risks. With commutes that can fall anywhere between 30 minutes to hours for some pregnant rural patients, the odds can be stacked against them.
Elehwany notes both healthcare workforce issues and the cost of dedicated OB equipment as two leading factors that place maternal care services on the brink of extinction. A report from NRHA also states that due to the demanding nature of obstetrics, many OB clinicians are reluctant to work in rural areas where they have fewer resources and less support.
However, in an innovative age of modern healthcare technology, there is still hope for a high probability of healthy pregnancies in rural America. One way healthcare organizations are lessening the burdens placed on OB clinicians is through implementing EHR integrations with the specialized tools that can be essential to an obstetrician’s workflow. By streamlining core labor management duties, rural hospitals may have a better chance of attracting and retaining maternal care experts without creating additional overhead costs.
Co-developed between MEDHOST and Clinical Computer Systems Inc. (CCSI), the resulting EHR integration tailored for OB and labor units can help improve care delivery in one of healthcare’s most highly regulated areas. The integration between MEDHOST and CCSI, the developers of OBIX Perinatal Data Systems, offers a textbook example of how healthcare interoperability can help address important issues like the rural maternity care crisis.
Targeting the perinatal workflow, the OBIX-EHR integration is designed to streamline patient data management in an OB setting by:
John Murray from CCSI emphasizes the important roles planning and testing play in these types of complex integrations. A level of vigilance is applicable to all HIT integrations but carries even more weight when considering key healthcare issues that may impact large portions of the population.
More integrations like the one between MEDHOST and CCSI can help preserve crucial and at-risk community healthcare services. Meanwhile, organizations like NRHA are working to drive awareness by forming dedicated coalitions on Capitol Hill. Following these examples, it becomes evident that creating solutions to help reverse a trend that sees OB services vanishing from our rural communities must become a priority for both the healthcare industry and government.
Through partnerships, policies, and innovative healthcare interoperability designs, we can all play a role in helping make the certainty of safe and healthy childbirth available to everyone across the country.