The need for more research into health information technology and maternal health outcomes

Abstract

Racial and ethnic disparities in maternal health persist in the United States despite continued efforts to make healthcare more equitable. The COVID-19 pandemic and overturning of Roe v Wade have further widened existing disparities in maternal healthcare. In this era of advanced technology, innovative tools like health information technology (IT) should be leveraged to address and reduce disparities in maternal health outcomes. Ongoing projects have demonstrated the potential for collaboration to prioritize patient autonomy in improving maternal health. However, further research is necessary to evaluate the effectiveness of these interventions in achieving equitable outcomes.

To the Editor:

Racial and ethnic disparities in maternal health persist in the United States despite continued efforts to make healthcare more equitable.^1,2 In 2022, the maternal mortality rate for Black women was 49.5 deaths per 100,000 live births, significantly higher than the rates for White (19.0), Hispanic (16.9), and Asian (13.2) women. ³ The COVID-19 pandemic ⁴ and overturning of Roe v Wade ⁵ have further widened existing disparities in maternal healthcare. A recent interrupted time-series analysis ⁶ suggests that behavioral changes resulting from the pandemic have led to increased incidences of gestational diabetes and hypertensive disorders of pregnancy, with more pronounced effects among Black, Hispanic, and less educated individuals. In this era of advanced technology, innovative tools like health information technology (IT) should be leveraged to address and reduce disparities in maternal health outcomes. ⁷

In July and August of 2023, the Deloitte Center for Health Solutions conducted a survey ⁸ that found that overall, more than 70% of survey respondents used digital tools to manage their specific health needs, for example, patient portals and mobile health applications to schedule appointments or communicate with their care team, to monitor reproductive cycles, or to educate themselves on maternal health. Their survey found that Black (30%), mixed-race (24%), and Hispanic (23%) respondents were nearly twice as likely as White (13%) respondents to say that digital tools for maternal health need to be more culturally informed. In another study ⁹ featuring seven group interviews with Black mothers in rural Georgia, the same theme emerged. Participants emphasized particular challenges that postpartum Black women face in relation to accessibility, racism, discrimination, and mental health and favored usage of a new, more culturally relevant mobile health application called Prevent Maternal Mortality Using Mobile Technology (PM3). Strategic usage of telemedicine-based care also can enhance access to maternal–fetal medicine services, particularly in underserved areas, as highlighted by the Society for Maternal–Fetal Medicine. ¹⁰

This dearth of research in health IT’s real-time effects on health becomes even more concerning amid the recent transition to the Trump administration, which has since ordered an executive order for the United States to withdraw from the World Health Organization (WHO) and initiated the freezing of federal grants which impact funding for health disparity research. Additionally, the Trump administration has indefinitely canceled meetings of the Health Information Technology Advisory Committee (HITAC), an advisory panel that helps the federal government establish rules and standards for using healthcare data and technologies. These moves are undoubtedly setbacks, countering our international counterparts like the WHO European region which drafted the Regional Digital Health Action Plan (2023–2030), which emphasizes the transformative potential of digital health technologies to improve health outcomes across the regions.

This letter is a call to action. The transformative potential of health IT to address maternal health inequities is widely recognized. Ongoing projects have demonstrated the potential for collaboration to prioritize patient autonomy in improving maternal health. However, further research is necessary to evaluate the effectiveness of these interventions in achieving equitable outcomes.