Maternal-fetal medicine program keeps moms close to home while improving access to care
“Switching from virtual to in-person care was a seamless transition. With the excellent open communication leading up to my hospital admission, I truly felt like there was no difference between virtual appointments and in-person appointments,” said HCA Healthcare patient Simms Schnorf. She was able to virtually see a maternal-fetal medicine specialist from Overland Park Regional Medical Center in Overland Park, Kansas while sitting hours away leading up to her delivery.
Her weekly telehealth visits were made possible by the maternal-fetal medicine (MFM) telehealth program at HCA Midwest Health, a seven-hospital health system and part of the HCA MidAmerica Division. Through this innovative and comprehensive program, Dr. Jessica Parrott at the Fetal Health Center at Overland Park Regional Medical Center, can virtually see patients.
The MFM telehealth program provides ongoing support and specialized consultation for women like Simms, who are facing high-risk pregnancies. Patients can receive expert care locally in the comfort of their obstetricians or gynecologists’ offices without the added burden of traveling to see a specialist.
“There are increasing numbers of women experiencing complications in pregnancy nationwide, and through expanded access and outreach, Overland Park Regional Medical Center is able to bring comprehensive, cutting-edge MFM services to community OB providers and hospitals, hopefully limiting their patients’ need for travel,” said Matt Sogard, chief executive officer (CEO) at Overland Park Regional Medical Center.
“Over the next three years, HCA Healthcare will continue to expand access to care for high-risk moms by adding teleMFM clinics, while layering on access to adult and pediatric subspecialists through telehealth solutions. COVID accelerated telehealth adoption making it easier to scale,” said Holly Elliott, vice president of HCA Healthcare’s women’s and children’s services.
Babies with complex needs, such as cleft lips/palates or heart defects, can be identified much earlier thanks to telehealth. This convenient option gives families and local physicians time and information to prepare and bring together resources, such as pediatric and surgical care, upon the delivery of the newborn.
The comfort of home for patients
Dr. Parrott added telehealth capabilities to the Fetal Health Center at Overland Park Regional Medical Center in January of 2020. At first, she was worried about how patients would react to it. “Patients are being referred to me because there is a significant abnormality with their baby and I often have to break the bad news to them. I feared doing it over a screen would lack the personal touch,” she said. But Dr. Parrott found patients were extremely appreciative. “I can unmask when I am talking to them since I am coming through a TV screen, and they can see my face and hear the empathy in my voice and know I am here to be supportive.”
Thanks to teleMFM, patients avoid having to take time off from work, secure childcare, or face costly travel for an ultrasound or checkup appointment with a specialist. Programs like these help solve ‘maternity care deserts’ which, according to a report by the March of Dimes, “are counties in which access to maternity healthcare services is limited or absent, either through lack of services or barriers to a woman’s ability to access that care.”
“This brings higher acuity care to the patient,” Dr. Parrott said.
Improved care for mom and baby
Three of Dr. Parrott’s recent patients shared their stories of how virtual care resulted in better outcomes for them and their babies.
Simms Schnorf felt like having an MFM expert virtually was a luxury. “I could receive expert specialty care for my high-risk complications from the comfort of my local OB’s office, where I already felt relaxed and at home.” She said traveling two hours for frequent appointments and scans would have presented a burden for her family and childcare needs. The virtual visits “eliminated an added stressor to an already stressful pregnancy,” said Simms.
She was diagnosed with vasa previa – where the placenta is over the cervix.
“Despite not being face-to-face, Dr. Parrott was knowledgeable about my specific case and accommodating to my questions and concerns. I felt completely satisfied with her understanding of what was happening with me and my baby. Our MFM sonographer at my local OB clinic was thorough and in communication with the doctor during the scan. Because of her expertise and open communication with the MFM specialist, I felt like there was no difference between the virtual appointment and an in-person appointment.”
She said the hospitality she received at OPRMC turned what could have been a scary time for her family into an enjoyable experience.
Jordan Griffith, who suffered from placenta accreta − when the placenta grows into the muscle of the uterus − shared that meeting with a teleMFM specialist put her and her husband at ease. “We absolutely loved the convenience of having virtual care. We live in such a small rural area that my OB office was an hour away itself, so being able to have appointments from Kansas City without driving was wonderful,” said Jordan.
“We saved so much time and money on fuel by staying in our regular OB office. It was tough enough to get a babysitter for our little children at home for the two hours we would be gone, let alone six-to-seven hours for each appointment. I was having to go weekly for appointments until being admitted. I wouldn’t know what to do if we would have had to make the trip to Kansas City weekly.”
When her symptoms progressed, Dr. Parrott called for her to be admitted to the hospital early.
Jordan said she was glad to be at the place known in the Kansas City region as “the baby hospital” during a spike in the pandemic. “It became very lonely being in my room for weeks without visitors or leaving my room, but the staff was always so kind, and I loved visiting with the nurses when they would do my bloodwork and vitals. When our baby arrived, I am so thankful to the doctors and surgical staff for saving both of us – and our NICU experience was amazing. They allowed my husband to be involved as much as he could while I was recovering and couldn’t be there. They were all so kind and explained every detail they could to us to keep us comfortable and knowing what was going on.”
After major surgery, Jordan and baby Casten are doing great. “He is our miracle baby, and a toddler tornado these days!”
Haley Shane also said she saved time and money by avoiding lengthy drives when she was referred to see Dr. Parrott through virtual appointments.
“She was amazing. She explained everything in words I could understand,” said Haley whose baby, Skylynn, was diagnosed with duodenal atresia.
Dr. Parrott said the condition caused fluid to build up around the baby. They monitored the baby virtually and brought Haley to Overland Park Regional Medical Center to remove the fluid around the baby and allow Haley to meet with additional specialists.
Haley was able to deliver full-term at the hospital and her daughter had a successful surgery 48 hours after delivery. “I loved everyone there − the nurses, the doctors, the surgeon! Everyone was amazing. I give this place a gold star!”
When she finally was able to meet Dr. Parrott in person, she said it was like they already knew each other.
She said baby Skylynn “is growing great – eating all her food and gaining weight!”
Flexibility for the provider
Currently, HCA Healthcare has teleMFM programs at 20 sites of care in five states including Texas, Kansas, Missouri, South Carolina and Virginia. These programs also provide flexibility for providers.
“I have the telehealth app on my phone, so if I have to run upstairs to round on a patient in our hospital, I can then beam in for the next appointment with a virtual patient. I can pull up the patient’s images and talk with them, and I don’t have to run back to the clinic,” said Dr. Parrott. Thanks to telehealth capabilities, she can see patients at three different locations across Kansas and Missouri and thus provide more services to the community.
She said it has also built great relationships with the OBs she works with at rural clinics. “They all have my cell phone number and they know they can reach out to me with any questions,” said Dr. Parrott. “They often text me and ask – ‘Is this what you would do?’ Our teleMFM collaboration gives them an additional level of security as they provide the best care they can.”
Experienced team for high-risk pregnancies
HCA Midwest Health is the leading healthcare provider in the greater Kansas City region and home to the Maternal-Fetal Medicine Network, the area’s most experienced team to support high-risk pregnancies. The health system offers four neonatal intensive care units (NICUs) and more than 175 specialists, including maternal-fetal specialists, neonatologists and pediatric specialty doctors such as pediatric surgeons, pediatric orthopedists, neurosurgeons, cardiologists, endocrinologists, infectious disease specialists, gastroenterologists, geneticists and neurologists.
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