Can Health Advocates Positively Impact Maternal Health Outcomes? A New Role is Emerging as an Extension of Clinical Teams
We all know the realities facing women who are pregnant in the U.S. Maternity deserts cover large swaths of our country. A shortage of OB-GYNs is only getting worse. We have largely turned to technology to combat these trends. But one of the largest missteps during the proliferation of digital health solutions in recent years has been the assumption that technology alone could cure what ails the healthcare system. As it turns out, we need more than tech to better support women through pregnancy.
Care teams as they are constructed today are already strapped for time and aren’t in a position to follow patients once they leave the doors of the clinic. But we can augment their bandwidth with health advocates who field inquiries from patients, serve as eyes and ears for the practice, connect patients to resources and escalate women with urgent needs so providers can care for them in a timely manner. This is a relatively new role within the maternal health space, but it is growing in adoption and importance. Below are keys to success for organizations who are considering using health advocates as an additional layer of support for the women they serve.
Combine tech and touch
As mentioned above, even the best app or platform can’t carry us to the promised land without actual human interaction. There are many occasions where patients want, or need, more than tech can provide. In many cases, there is no substitute for a real person on the other end of the line, or app. When we launch advocacy support for client populations, we consistently see significant utilization of these services.
On the other hand, it isn’t possible to scale a human only approach. You need capable technology to support the advocate and the patient population. You need digital tools that can address basic or routine requests while helping prioritize and triage patients with urgent needs. With maternal health, we see similar patterns as common chronic conditions. About 20 percent of patients are at the highest risk for adverse outcomes, while 80 percent of the population is on a more positive trajectory. So, we must use technology to identify the 20 percent, and human touch to help these women navigate to the most appropriate care.
Develop a complete picture
To paint a fully accurate picture of each patient that advocates are trying to help, you need access to multiple types of information. Of course, this starts with concrete data (i.e. EHR sourced) about the individual’s health, as well as self-reported health behaviors. You also need insights related to their social and lived environment (i.e. social determinants of health). Finally, you need to assess the patient’s activation level. What is the individual’s health literacy? How confident are they? How proactive will they be in engaging with care?
Defining someone by their conditions, whether that is diabetes or a high-risk pregnancy is not the way patients think about it. They are experiencing the condition in the context of the ecosystem that is their daily lives. As a result, the combination of a patient’s health status, current behaviors, SDoH needs and level of activation provides the key to effective engagement. Each of these dimensions changes the recipe for outreach by an advocate. As an example, it is easy to imagine how two patients with similar demographics and health statuses could require much different approaches based on their activation levels. Too often, care teams don’t have a complete picture of the patients they are serving. This leads to disconnects and missed opportunities.
Get to the WHY
Some approaches to advocacy, as we also see in coaching, are very didactic in nature, focused squarely on education and driving compliance with certain actions or behaviors. Other programs incorporate more open-ended and exploratory techniques, searching for intrinsic motivations they can tap into in order to drive positive change.
Most often, women don’t fully engage in healthcare when they don’t have a clear connection between their behavior and how that impacts health outcomes. In other words, if they don’t understand the “why,” we can’t expect them to do “what” we need them to do.
When you ask women questions about what’s most important to them, and then make connections to the behaviors that impact this, the conversation shifts. Advocates are in a unique position to help patients understand the why and to set more context for instructions and care plans they receive from their providers.
Facilitate the patient/provider relationship
At the end of the day, the role of the advocate should be to strengthen the bond between patients and their providers. This requires trust to be built on both sides. You need patients to trust that advocates are there to help them navigate the system and support their goals. You need providers to trust that advocates are there to reduce their overall burden, while helping them extend the support they offer to patients between visits. When introducing advocates to the care team, education, training and promotion is required among patients, but also among all physicians and staff members who are part of a practice or health system.
Patients do not retain a majority of what is shared with them during physician visits. Meanwhile, physicians have limited time with patients during office appointments and no way to encourage and engage patients between visits. When patients and providers are brought together through technology and human touch on an ongoing basis, it leads to better outcomes for moms and their babies.
Deliver clear value
Effective solutions in this space will add value in meaningful ways. This means going beyond what patients can receive from Dr. Google. There is a plethora of information available via the Internet or through consumer apps that address pregnancy.
These solutions also must do more than simply replicate what’s happening in the physical world. Just creating clinics in the air doesn’t solve for much. While access is a critical issue, specifically for maternal health, we also need to fill gaps in our current approach to care. It’s not just access to a physician or a clinic. We need a different approach to maternity care if we expect to improve the outcomes we are experiencing. That is a big part of why advocates are such a critical addition to the team.
Want to learn more about how health advocates are being deployed to support women and improve maternal health outcomes? Contact us today.