How Digital Health Solutions in Massachusetts and Beyond Can Save 3 Million Mothers and Babies

August 9, 2019
Source 
MassDigitalHealth.org editors

Every year, 2.5 million babies around the world die before reaching their 1-month birthday. In the United States, this translates to a national average of 5.8 deaths for every 1,000 babies born. While this rate is low in comparison to the global rate of 29 deaths per 1000 live births, the United States trails behind 53 other countries—including Greece, Canada, Germany, Italy, France, Iceland, and Japan among others—where these rates shrink to as low as 1.8.

As a nation, we are failing our children, but states are making strides in the right direction. With a rate of just 3.7, Massachusetts has the lowest infant mortality rate in the country. Other states should strive to follow Massachusetts’ lead, driving down mortality rates across the country and throughout the world.

Massachusetts is the country’s leading innovation hub and, with the heightened interest and recognition of the value of digital technologies to advance health, digital health innovation is emerging as a powerful means to the end of infant and maternal mortality. So, the question is: How can digital health impact maternal and child health in Massachusetts, the United States, and the world?

Nutrition: Appropriate Care Before, During, and After Pregnancy 

Did you know The World Health Organization estimates that 133,000 lives can be saved with appropriate nutritional care before, during, and after pregnancy? To drive progress towards achieving this goal, we look to current digital health technologies impacting and advancing nutrition. One digital health solution with the capacity to impact nutritional health and bring us closer to saving these lives is Nutrimedy, a Boston-based startup.

Nutrimedy: Nutrition Reimagined

CEO Karolina Starczak, a registered dietician with a diverse background in healthcare, is leading her team on a mission to improve health through access to convenient, expert, personal, and affordable nutritional counseling around the world. Using a novel online wellness platform integrating science, technology, and behavioral health, Nutrimedy is redefining telenutrition and bringing health to the people who need it most: Expectant mothers.

At Nutrimedy, the critical importance of maternal nutrition during pregnancy cannot be understated. With the implementation of the nuExpecting program, expectant mothers can meet anytime, anywhere with expert nutritionists to take the guesswork out of eating for two and ensure a healthy mom, a healthy pregnancy, and a healthy baby.

Pregnancy: the Forgotten Nine Months

National statistics are reported for both maternal and infant mortality rates, but what is often overlooked is the importance of care during pregnancy. According to the World Health Organization, 290,500 lives can be saved with appropriate, affordable, and effective care throughout pregnancy. One key area in desperate need of this attention is mental health.

More than half of all pregnancy-associated deaths had a documented mental health diagnosis. With maternal suicide emerging as a leading cause of maternal death, and 50% of pregnancy-associated depression undiagnosed, identifying at-risk women is critical in ending this epidemic. Massachusetts is fighting to bridge this gap through WIC Program screening of all pregnant participants, Massachusetts Department of Public Health home visiting programs, and the 2016 policy to cover depression screening for all new mothers on MassHealth. Massachusetts has the second lowest maternal mortality rate in the country, and these initiatives highlight steps the state is taking to further drive down that rate and help mothers survive.

One in seven women suffer from depression during or just after birth, and in addition to policy changes, many organizations in Massachusetts lean on digital health solutions to combat this challenge. For example, Harvard Pilgrim has partnered with Doctor on Demand, a national telemedicine provider group of board-certified physicians, to proactively expand access to behavioral health services including treatment for postpartum depression.

Digital health startup, UpLift, just closed $1 million in seed funding to develop the technology of their mental health app. UpLift employs cognitive behavioral therapy to help users with depression, cutting rates in half and fighting an epidemic that affects women throughout the world.

Small and Sick Babies: the Importance of Caring for our Most Vulnerable

Newborn babies represent one of the globe’s most vulnerable populations, with small and sick newborns—particularly those requiring treatment in neonatal intensive care units—the most at-risk. The first 1,000 days of life are critical for infant growth and brain development, and as many as 580,000 lives can be saved through advances in neonatal care. Massachusetts, home to two of the nation’s top 10 hospitals, is dedicated to improving newborn health outcomes and eliminate health inequities through programs with The Neonatal Quality Improvement Collaborative and The Perinatal-Neonatal Quality Improvement Network.

The Human Milk Quality Improvement Collaborative Project, a NeoQIC initiative, unites NICU’s across the state to increase nutrition of neonates, with a special emphasis on maternal breastfeeding for low birth weight infants.

Astarte, a female-led startup that participated in the MassChallenge HealthTech accelerator in Boston, is developing a digital health solution to advance care during this critical period. Founded by Tracy Warren and Tammi Jantzen (both mothers themselves) and inspired by a visit to Brigham and Women’s Hospital in 2015, Astarte Medical is the only precision medicine company using software and predictive analytics to improve neonatal outcomes. With a particular emphasis on preterm infants, Astarte has developed NICUtrition, an integrated data set of feeding protocols, microbiome profiles, and clinical information to standardize protocols and customize treatment. Sparked by that initial visit to Brigham and Women’s Hospital, and armed with the research the hospital was conducting on preventing newborn deaths secondary to GI illness, NICUtrition was created to marry evidence-based research, big data analysis, and innovative software. With NICUtrition, newborns - even the smallest and sickest - have the potential to grow, survive, and thrive.

Life After Birth: Caring for Babies When They Leave the Hospital

A report from the WHO and UNICEF estimates that 1,910,000 newborns’ lives could be saved with advancements in care during their first week and early life. Massachusetts recognizes the critical nature of this period and is employing programs across the state—including the MIECHV, the EIPP, and the Welcome Family Program—to educate, intervene, and support mothers in these first few days of parenthood.

A focal area of support offered to new mothers is breastfeeding. With an incredible life-saving potential (breastfeeding can prevent over 800,000 deaths), it is no surprise that breastfeeding levels are on the rise in the United States, with 83.2% of infants breastfed and 57.6% and 35.9% continuing at 6 months and 1 year respectively. But despite these promising statistics, less than a quarter of the nation’s mothers and infants followed the 6-month exclusive breastfeeding recommendation. Why are rates so low? Mother’s aren’t getting the community support they need.

 

 

 

Pumpspotting, founded by mom and breastfeeder Amy VanHaren, is a two-time MassChallenge alum (MC Boston and MC HealthTech) that was championed by Boston’s Brigham and Women’s Innovation Hub during its time at the accelerator. On a mission to make breastfeeding and postpartum life less isolating, pumpspotting is a community-driven breastfeeding and digital health platform that connects and nourishes new mothers through encouragement, advice, employer support, or even finding a place to pump. Women’s health has historically been underfunded and overlooked. But with pumpspotting, women are being seen and their health—and the health of their new baby—is being put first.

Boston-based Ovia Health, the market leader in maternity and family benefits, has successfully helped over 11 million people navigate their parenthood journeys by simply listening and advocating for what women need and deserve. Driven by data and research, Ovia has developed apps for fertility, pregnancy, and parenthood that empower women and families to get the benefits and care they need. This simple act of asking and listening has improved clinical outcomes, reduced costs associated with infertility and pregnancy, and helped parents successfully return to work, creating a better start to mom and baby’s life together.

The Future of Maternal and Child Health

While digital tools may not be the silver bullet, they are one piece of the puzzle when it comes to addressing the issue of maternal and infant mortality. It isn’t an easy problem to solve, but innovators and providers are making headway by talking to patients and listening to the communities most at risk. Through community organizations and innovative digital health technologies, we can fill this healthcare gap and play a role in ending this epidemic. After all, with the potential to save 3 million lives, women’s health is worth it.