Expect with Me: Enhancing Clinical Care Through a Patient-Centered IT Platform

Four million women give birth annually in the US. Despite biomedical advances, rates of preterm birth and low birthweight have been intransigent for three decades, at a cost of \u3e$26 billion annually. Access to care has not affected prevalence of adverse outcomes, indicating that prenatal care in its current form will not solve these problems. Expect With Me is an innovative group prenatal care model with strong technology infrastructure. Based on research and clinical guidelines, Expect With Me group prenatal care is conducted with 8-12 women of the same gestational age. There are ten 120-minute sessions, facilitated by two healthcare providers, following a structured curriculum and supported by an educational/social media clinical worksite. Group sessions include online health tracking, education, skills building and discussion regarding perinatal topics to support healthy pregnancies. In two randomized controlled trials (\u3e2,200 moms/babies), group prenatal care resulted in outcomes as good or better than individual care (e.g., 33% reduction in preterm birth and small for gestational age; 50% improvement in birth spacing). Estimates find that group care can save approximately $890/birth, with the potential to reduce societal costs related to early intervention, special education and lost productivity. Expect With Me\u27s clinical worksite supports both research and clinical objectives. Our HIPAA-secure site with patient portal enables real-time data collection and management. Clinicians use the worksite to schedule/enroll patients and track health outcomes. With personalized profiles, patients use the worksite to log vital signs and set/track health goals. The social network component of the worksite allows women to gain support by posting updates, messaging group members and providers, participating in discussions, and accessing educational resources. Expect With Me is currently being evaluated in a multi-city study, with \u3e1000 women. Results will enhance best practice guidelines and refine Expect With Me, including IT infrastructure and app development