IN FOCUS: Innovators Bring Telemedicine Tools to Maternal Care
By: Jennifer Peters
February 28, 2021
Photo courtesy of Nuvo Group
The COVID-19 pandemic proved there’s an increasing need for advancements in telehealth. While some basic forms of medical care are straightforward to handle remotely (e.g., wellness visits, mental health), care that requires hands-on monitoring is much more difficult. One area of telemedicine that’s seen recent growth—and is primed for more—is prenatal care.
While maternal mortality have dropped, there were still 17 maternal deaths for every 100,000 live births in the U.S. in 2018. Now, medical device companies around the world are working to bring maternal telehealth options to more moms-to-be in the hopes of lowering the mortality rate and giving expectant mothers more choices for quality care.
“If you look at different categories of care, like chronic care and primary care, they’re much more mature as virtual-first categories, where pregnancy is really immature in terms of telehealth adoptions,” said Debra Bass, U.S. president and chief marketing officer of Nuvo Group, an Israeli company that recently introduced a remote pregnancy monitoring platform, called INVU. “Part of it was risk aversion of the part of OBs, and part of it was not having the tools … Going forward, we want to enable better outcomes.”
Among the other companies innovating with remote maternal care are:
- Reach, which wants to get heartrate monitors to expectant mothers
- Sibel Health, which is creating wireless sensors to monitor babies as well as birthing mothers
- Truefit, which is marketing the VidaRPM app to help expectant mothers and their doctors monitor important health factors
Each of the devices offers mothers-to-be and their providers important tools to help them track the health of both the mother and the fetus and do so from the comfort and safety of the woman’s home.
At Nuvo, the impetus for moving into the remote maternal care space came from founder, Oren Oz, whose wife experienced a high-risk pregnancy that “tethered” her to the doctor’s office, which she had to visit several times each week—adding stress to an already difficult situation.
"Research shows that the current pregnancy monitoring guidelines, which recommend 12–14 in-office monitoring sessions, place a burden on expectant mothers that is difficult to bear during the best of times—and frankly, dangerous during a pandemic," Bass said. "Moms should not be tethered to 100% percent brick-and-mortar care in an age where technology enables patients to access care from anywhere.”
The average woman sets aside more than one hour for each in-person prenatal visit, which adds up to more than 800 minutes at in-person prenatal visits over the course of a pregnancy, according to a recent study conducted by Nuvo. More than 7 in 10 expectant and new mothers said they were worried about their health and safety while going to doctors’ offices during the pandemic.
“Based on the needs of today's patients, it's important for providers to start extending telehealth services beyond video 'televisits' to include comprehensive remote monitoring—both during the COVID-19 pandemic and beyond,” said Dr. Elizabeth Cherot, MD, chief medical officer of Axia Women's Health, the first U.S. partner to offer patients the option of using the INVU for remote pregnancy monitoring.
But getting the level of care at home that could be provided in the office isn’t always as simple as downloading an app or strapping on a wearable device. For an at-home device to truly benefit the mother and provide useable information to the provider, it has to be capable of collecting high-quality data, while also being simple to use for the patient. For devices that don’t need to be worn or used 24/7, that means making it accessible right out of the box and ensuring that little-to-no professional intervention is needed to ensure proper functionality of the device.
“On one hand, you want a simple, intuitive, self-administered device, but on the other hand, you want medical-grade data… and you can’t compromise on either of them,” said Amit Reches, chief technology officer for Nuvo.
For the INVU platform, this meant their at-home device needed to be able to track maternal fetal activity while still being simple enough for patients to use on their own. That’s a difficult task even in the office because of the environment of the womb as well as the interference of the mother’s heartbeat on the readings. When monitoring during an office visit, “you’re constantly chasing the baby,” Bass said, with sensors needing to be replaced multiple times. That’s something a mom-to-be can’t do at home.
To help solve those issues, the INVU device utilizes redundancies, with multi-modal, mutually reinforcing sensors that capture the sounds of both the mother and baby’s heart as well as capturing the electrical signals produced in the womb. The system’s eight sensors can be placed once and then left alone. The device has received 510(k) clearance from the FDA for remote maternal heart rate monitoring, and Nuvo has filed another 510(k) notice to add a uterine activity module.
Whether intended for use in telehealth or in brick-and-mortar doctors’ offices, update technology is vital to providing quality maternal health care. But new technologies are looking to take maternal care even further. Reches said he’d like to see artificial intelligence integrated into today’s monitoring tools, technology that could be used to predict outcomes and revolutionize the health management for expectant mothers.