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OBGYN: Providing prenatal care in group visits

The idea of seeing expectant mothers who are at about the same stage of pregnancy together in a group for prenatal care is not new – it was described in the 1990s.  Generally, it is for low-risk patients.  Mazzoni & Carter discuss findings in the literature as to the effectiveness of this approach.  A popular model is called Centering Pregnancy, which is addressed in the other articles cited below.

Selected Sources:

Mazzoni, S.E., and Carter, E.B. (2017, February 9). Group prenatal care. American Journal of Obstetrics and Gynecology.  Click here for the publisher’s website: http://www.ajog.org/article/S0002-9378(17)30185-0/pdf

Crockett, A.H., and others. (2017, January). The South Carolina centering pregnancy expansion project: Improving racial disparities in preterm birth. American Journal of Obstetrics and Gynecology. 216(1 Supplement), S424-S425. Click here for free full text: http://www.ajog.org/article/S0002-9378(16)31441-7/pdf

Carter, E., and others. (2016, January). Group compared to traditional prenatal care for optimizing perinatal outcomes: A systematic review and meta-analysis. American Journal of Obstetrics and Gynecology. 215(1 Supplement), S382.  Click here for free full text: http://www.ajog.org/article/S0002-9378(15)02081-5/pdf

Garretto, D., and Bernstein, P.S. (2014, January). Centering Pregnancy: An innovative approach to prenatal care delivery. American Journal of Obstetrics & Gynecology, 210(1), 14-15.  Click here for free full text: http://www.ajog.org/article/S0002-9378(13)01039-9/pdf

Fausett, M., and others. (2014, January). Centering Pregnancy is associated with fewer early, but not overall, preterm deliveries. American Journal of Obsetrics & Gynecology, 210(1, Supplement), S9.  Click here for free full text: http://www.ajog.org/article/S0002-9378(13)01111-3/pdf  Posted by AHA Resource Center (312) 422-2050 rc@aha.org

HOUSE CALLS: Smart phone apps and home visits

Entrepreneurs are developing businesses that will bring physicians or nurse practitioners to the home or workplace or other location where the patient is, based on smartphone apps.  Here are some of the new companies:

In the case of Mend, the charge for this service is discounted to $50 for the first visit and $199 for any subsequent visit (with college student and staff discounts available).  The nearest competitors would be retail clinics located in chain pharmacies and big box stores.

Sources: Goodman, M. (2015, Oct.). Urgent care goes Uber. D Magazine. Retrieved from http://www.dmagazine.com/publications/d-ceo/2015/october/urgent-healthcare-smartphone-services 

Jolly, J. (2015, May 5). An Uber for doctor housecalls. The New York Times. Retrieved from http://well.blogs.nytimes.com/2015/05/05/an-uber-for-doctor-housecalls/?_r=0  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

PHYSICIAN VISITS: How often should you see your doctor?

Little is known about how often you should see your doctor, or the best interval between follow-up visits to physicians, according to the authors, who are all affiliated with Harvard Medical School.  It’s a question of interest in this era of accountable care organizations (ACOs), in which new care models are being fashioned.  The authors do not end up making any recommendations as to the optimal frequency for physician visits, but they do present some suggestions as to how to begin to think about making the health care system more efficient.  For example, ACOs could re-engineer the referral process to specialists to avoid unnecessary first visits.  Also, technology could be used more effectively to replace face-to-face encounters in the office or clinic.

Source: Ganguli, I., Wasfy, J.H., and Ferris, T.G. (2015, Apr. 6). What is the right number of clinic appointments? Visit frequency and the accountable care organization. JAMA, E1-E2. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=2241120&resultClick=3  Posted by AHA Resource Center (312) 422-2050, rc@aha.org