Health technology systems emerging as safety net tools for high-risk prenatal care: a qualitative study

The impact of health technology systems (HTS), including telehealth and patient portals, on patient-provider communication, especially among women with a high-risk pregnancy who need more in-depth medical assessments, is not fully understood. Hence, this study explored the experiences of women experiencing high-risk pregnancies and perinatal healthcare providers with telehealth and patient portals using the patient-provider communication framework.

This qualitative study used a phenomenological approach. Purposeful sampling was used to recruit fifteen women experiencing high-risk pregnancies and eight providers from two obstetric practices, predominantly serving women on Medicaid. Semi-structured interviews were conducted, transcribed, and then analyzed using inductive thematic analysis.

The themes and subthemes were developed iteratively. The main themes were consistent across both groups while the subthemes varied. The main themes included benefits of and barriers to HTS, patient-provider interaction, system-level actions, and future recommendations. The analysis revealed that while HTS improved access to care and empowered patients, both groups faced significant challenges. Providers noted that HTS do not address the complex needs of high-risk pregnancies and the issue of workflow disruption. Patients appreciated the convenience of HTS, but reported delays in communication and limited interaction with healthcare teams.

HTS are emerging safety net tools that can improve access to prenatal care and increase shared-decision making and patient empowerment. High-risk pregnancy needs require multifactorial solutions to ensure comprehensive care leveraging HTS, with patient-provider communication at the core of managing these challenges. Healthcare systems need to invest in improving HTS to meet the needs of vulnerable populations.

This study explored the experiences of women experiencing high-risk pregnancies and perinatal healthcare providers with health technology systems (HTS), specifically telehealth and patient portals. Interviews were conducted with fifteen women with high-risk pregnancies and eight healthcare providers from two obstetric practices, predominantly serving women on Medicaid. The analysis revealed that while HTS improved access to care and empowered patients, both groups faced significant challenges. Providers noted that HTS do not address the complex needs of high-risk pregnancies and the issue of workflow disruption. Patients appreciated the convenience of HTS, but reported delays in communication and limited interaction with healthcare teams.