About the Personal Prenatal Health Record (PPHR)
The PPHR program of Maternl© is a unique, new software program1: a portable, secure and interactive electronic personal health record, designed specifically for pregnant women in underserved, urban communities. Many women in urban, underserved communities do not have readily accessible and continuous access to pre-natal care, may get fragmented care at multiple facilities ("unregistered" patients) and may present to a provider in one or more of those facilities who is unfamiliar with her health history, family history and her prior physical examinations and findings, knowledge of which would contribute to a higher quality and safer prenatal visit / encounter. As a portable, mobile, secure and interactive personal health record, Maternl©, designed specifically for pregnant women, replaces the commonly used handwritten "paper card" format to record pre-natal care information. Such a card carried by the patient, sometimes referred to as a "Pregnancy Passport," is sub-optimal in today's contemporary healthcare and health information technology environment. A readily available Internet-based program / mobile smart phone / tablet application to collect, store and access personal prenatal healthcare information, designed specifically for the target population, could improve the quality of the point-of-service encounter for transient and "unregistered" patients arriving for pregnancy related care. As perinatal morbidity, mortality and prematurity rates are higher in urban, underserved, minority communities, Maternl© utilizes the many advantages of health information technologies to improve storage, access and retrieval to this important information as well as disseminate pregnancy related information based on decision support algorithms and the users'current needs.
Many women in urban, underserved communities do not have readily accessible and continuous access to pre-natal care, may get fragmented care at multiple facilities ("unregistered" patients) and may lack a primary pre-natal healthcare provider who is familiar with the patient, her health history and family history, her prior physical examinations and her laboratory/Ultrasound findings. Providers of care to pregnant women in urban settings often see patients in an emergency setting such as the labor floor or emergency room without access to prenatal visit information such as their pregnancy / medical history, prior examinations and laboratory and imaging findings. These render the emergency visit suboptimal and oftentimes unsafe. Thus, there is a need for a reliable and immediately available prenatal health record in order to provide improved quality of the prenatal visit.
Maternl© is easily useable and always accessible as a mobile, Internet-based application, intended for a specific target population of urban underserved pregnant women, can be designed to collect, store and permit access to personal prenatal healthcare information so as to improve the quality of the point-of-service encounter for transient and "unregistered" patients arriving for pregnancy related care. Maternl© is designed to be culturally and health-literacy appropriate, and should be more effective than current attempts for target population to arrive at a healthcare facility with their pre-natal information; i.e. paper card.
The PPHR of Maternl© addresses:
1. Higher rates of perinatal morbidity, mortality and prematurity in urban, underserved, minority communities
2. Coincident disparities in access to prenatal healthcare services and access to and use of available health information technologies. (This division becomes particularly concerning as health information technologies play a greater role in the personal health of the patient / consumer in the general population.)
3. An outdated currently utilized "paper chart format" for maintaining prenatal care information ("Pregnancy Passport")
4. A compelling need to improve compliance with accepted prenatal care standards and procedures and patient education needs via the use of innovative, multiple platforms and approaches
Among the many contemporary tenets incorporated in a "Digital Health" milieu, two are overarching: a persistence of what has been called the "digital divide" and an available, accessible and widely accepted "patient-centered record" that goes "everywhere the patient goes."3 Detmer et al 4 have proposed a concise yet elegant characterization of what is the "digital divide." They define the digital divide as the disparity between those with and those without "the ability to effectively use digital information technology." Major contributors to the digital divide include:
Racial and social disparities Heath illiteracy Special needs Lack of financial resources for health care safety net organizations
It is the mission of Maternl© to addresses these issues in an effort to improve the health of all pregnant women, world-wide.
1Maternl© was developed as the author/founder's Masters' Thesis(Capstone) at the Oregon Health and Science University.
2 Dan Bowman. Fierce Health IT. Health IT momentum must be maintained through 'pivot,': [homepage on the Internet]. [cited 5/1/2014]. Available from: http://www.fiercehealthit.com/story/health-it-momentum-must-be-maintained-throughpivot-desalvo-says/2014-01-24#ixzz30UipEKJi
3 Detmer D, Bloomrosen M, Raymond B, Tang P. Integrated personal health records: transformative tools for consumer-centric care. BMC Med Inform Decis Mak 2008 Oct 6;8:45.