Like an octopus whose eight arms are capable of simultaneously completing eight separate tasks, a mother with a newborn baby is required to juggle several competing priorities, all at the same time. In the first few hectic months after giving birth, a mother’s own health can fall to the wayside in competition with other responsibilities, yet, with the potential for life-threatening complications arising during this time, it’s critical that mothers get the healthcare they need. Enter MOMitor™, a perinatal medical monitoring smartphone application that supports mothers during pregnancy and after delivery by allowing patients to check in on their health from home.
One of the application’s founders and its head of outcomes assessment, Amie Goodin, Ph.D., an assistant professor of pharmaceutical outcomes and policy in the University of Florida College of Pharmacy, said MOMitor™ was developed in 2021 in response to the high rate of preventable maternal deaths and complications faced by women who give birth in the United States, especially in Florida. The Centers for Disease Control and Prevention report that 80% of pregnancy-related deaths are preventable. A smartphone app that facilitates physical and mental health screenings to remotely monitor postpartum health, MOMitor™ fills the gap between postpartum women and at times lifesaving care.
“Women typically only get one or two visits to their doctor covered by insurance in the first six weeks after they give birth, and this is also the most dangerous period for postpartum complications, with over 70% of maternal deaths occurring in the first six weeks after delivery,” Goodin said. “About 40% of women are not even able to attend these few postpartum visits for screening and care, as there are major barriers related to childcare, transportation and competing schedules for work that women face during this hectic time.”
Preventive and Responsive Care
MOMitor™ monitors changes in a mother’s mental health related to mood, such as depression and anxiety, as well as symptoms or conditions that may warrant in-person assessment or care, like blood pressure monitoring, the potential for infection, lactation concerns and blood sugar monitoring in those with diabetes. The app checks for service needs, such as food, housing, transportation or interest in a home visit from a nurse. It also facilitates clinician-directed medication adjustments when appropriate.
When a concerning response is received from a participant, they quickly get a call from a registered nurse employed by MOMitor™ and UF Health for a thorough assessment, which may lead to in-person care or further monitoring. To date, MOMitor™ has enrolled more than 5,000 pregnant or postpartum women across Florida, many of whom reenroll each time they become pregnant.
“MOMitor™ allows moms and moms-to-be to take charge of understanding their mental and physical health changes remotely, from their phone, and gives them immediate, direct access to clinicians when they have questions, problems or are feeling uncertain,” Goodin said.
Within the first year that MOMitor™ was available, the app recommended a patient visit the emergency department, where she received a lifesaving clinical intervention. Similar cases followed. In response to encouraging feedback from participants and their care teams, MOMitor™ has expanded the range of mental and physical health symptoms and conditions that its clinician team is able to monitor and treat remotely. An ongoing partnership with the Florida Department of Health boosts the reach of the MOMitor™ Program, which is led by Kay Roussos-Ross, M.D., a clinical professor in the UF College of Medicine and the division chief of Academic Specialists in General Obstetrics and Gynecology.
“We currently serve both pregnant women and new moms through one year postpartum in 19 Florida counties through the Department of Health’s Florida Telehealth Maternity Care Program. We also partner and collaborate with Healthy Start on the joint initiative MOMstart, so MOMitor™ participants can receive an in-home visit from a registered nurse within the first week following hospital discharge from delivery. At this visit, the participant has their maternal recovery and support needs assessed and is then provided with education, community resources and guidance as suited for their needs,” Roussos-Ross explained. “This is all a supplement to MOMitor’s remote monitoring and clinician communication.”
It Takes a Village
The UF Health-based team behind MOMitor™ spans several health sciences: Roussos-Ross, a triple-boarded physician in obstetrics and gynecology, psychiatry and addiction medicine, oversees patient care and safety, while Goodin’s background in pharmaceutical outcomes and informatics lends itself to assessing the app’s patient outcomes and efficacy. Deepthi Varma, Ph.D., M.Phil., M.S.W., a psychiatric epidemiologist and research assistant professor in the UF College of Public Health and Health Professions, oversees the app’s user experience and engages in digital health intervention research, and Tony Wen, M.D., a professor and chief of the UF Division of Maternal-Fetal Medicine, supervises MOMitor’s clinical care teams. Over the last half decade, the team has grown to also include research coordinators, nursing team members, a data scientist, therapists and contributions from several UF biostatisticians and informaticians. Goodin said it’s her team’s collaborative, cross-discipline approach that has enabled MOMitor™ to create such a positive impact on patients’ lives.
“Participants have given us some powerful examples of what MOMitor™ has meant to them,” Goodin said. “We’ve heard feedback like, ‘I didn’t have to call a doctor. Somebody called me.’ One participant said MOMitor™ ‘helped push me toward getting medical help that I otherwise might’ve avoided,’ and one even said, ‘It saved my life. I wouldn’t have checked my blood pressure were it not for the app.’”
The MOMitor™ program is also currently part of a research study open to those who are pregnant, delivering their baby soon or recently postpartum. To enroll, participants must reside in Florida, be at least 18 years old and be able to speak and read either English or Spanish. Through a partnership with the Florida Department of Health, smartphones and data plans are available to participants who do not have access to them. To sign up or for more information, visit: https://obgyn.ufl.edu/patient-care/momitor/.