Peoria, Illinois,
13:28 PM

OSF OnCall plugs pregnancy and postpartum care gaps for Medicaid patients

Pregnant woman connecting for virtual visit

Samantha, a 25-year-old woman who recently had her second baby, enrolled in a new program through OSF OnCall Connect that provides support to pregnant women in Illinois with Medicaid insurance.

The program likely saved her life. Eight days after she delivered a healthy baby girl, Samantha messaged her care team through an application that can be accessed on a tablet or smartphone that serves as a key connection and education tool available through the OSF OnCall Connect pregnancy-postpartum program. She explained she was suffering from a terrible migraine headache and chest pains.

The OnCall Connect nurse immediately recognized the significance of her symptoms and notified the OnCall advance practice provider who recommended Samantha go directly to the Emergency Department. She had a serious condition called postpartum pre-eclampsia, which causes a person to have high blood pressure and high levels of protein in their urine. It can lead to brain damage, stroke and death if left untreated. But, Samantha was treated with magnesium sulfate and medication to reduce her blood pressure, and she’s expected to make a full recovery. Samantha is a Black woman, and in the United States, Black women are three times more likely than white women to die as a result of pregnancy.

A new report from the Centers for Disease Control and Prevention (CDC) found 80% of maternal deaths between 2017 and 2019 were due to preventable causes, and many of the deaths occurred within the first year after giving birth. The statistics are behind the new OSF program that was launched under the umbrella of a state-funded program called the Medicaid Innovation Collaborative.

The OSF OnCall Connect pregnancy and postpartum program was launched in August. Kate Johnson, clinical supervisor for Digital Care at OSF, says more than 100 women signed up within the first two weeks. She believes pregnant women want additional support, and they’re eager to have the 24/7 connection.

“It provides check-in questions, routine questions, like ‘Are they having any signs of infection, UTI symptoms? Are they struggling with breastfeeding; having any depression symptoms?’ And if they answer in any kind of an alarming way, that lets our nurses know right away … sends them an alert, and we're able to contact those patients via telephone and triage if we need to.”

Women on Medicaid can self-enroll in the free program starting eight weeks into their pregnancy by going online to register. A welcome kit will be delivered and includes instructions for downloading the easy-to-use app and a blood pressure cuff for taking regular readings. Women can also enroll in the postpartum program without having participated in the pregnancy support.

Weekly Educational Info is Delivered 

Johnson says women will get new education messages each week throughout their pregnancy and postpartum.

“I think the education that we provide those moms during their pregnancy is awesome because it's getting them ready to deliver their baby. So, helping them think about things like how they want to feed their baby, birth plan, pain management for their delivery, things of that nature.”

The CDC study found mental health issues were among the preventable, pregnancy-related conditions that lead to higher mortality rates. Johnson says that’s why the program offers depression screening upon enrollment in the pregnancy program, and women have the option to enroll in the postpartum portion. For postpartum support, they can indicate the type of support they need, such as selecting whether they delivered  vaginally or via C-section or if they require information on infant care.

Even though women are screened  for depression in the hospital after they give birth, it’s often six weeks before they have a follow-up appointment. Johnson says this is too much time, and pregnant women too often suffer in silence.

“So, we will be screening her right upon enrollment into the postpartum loop. And then we'll do a two-or three-week check-in to make sure emotions are doing okay. There is such a huge change in emotions postpartum with the changes in your hormones and bringing a baby home plus the sleep deprivation. So, we want to be there to support them in that initial six weeks before they see their provider.”

The OSF OnCall Connect pregnancy and postpartum offering for women with Medicaid also screens for social determinants of health – all those factors outside of a medical office, such as food insecurity, financial struggles, housing and transportation, to fill the gaps that could contribute to the health of them and their baby. Johnson shares what the program is uncovering so far.

“I think what we're seeing mostly is patients who are struggling with transportation to get to their actual OB provider appointments, so we are able to align transportation for them in most cases. Just this past weekend, we had a patient that had no car but needed a prescription. So, we aligned her with a pharmacy that delivered those medications directly to her door.”

The women are screened for all needs again after birth. Johnson shares one woman admitted she had no supplies at her home, either for herself or her newborn, and she was connected immediately so she could have what she needed going home. Women in the program also have the option of being connected with a digitally-enabled community health worker who can help them navigate ongoing support from community-based organizations.

Video clips with Kate Johnson, clinical supervisor of Digital Care, OSF OnCall Connect

View Kate Johnson-Women want 24-7 support
Kate Johnson-Women want 24-7 support
View Kate Johnson-Education is part of the support
Kate Johnson-Education is part of the support
View Kate Johnson-Depression can hit weeks after delivery
Kate Johnson-Depression can hit weeks after delivery
View Kate Johnson-Women will get help meeting all needs
Kate Johnson-Women will get help meeting all needs