New Effort Underway to Prevent Premature Births

By Kelly Quinn
Monday, April 29, 2019

Premature births are the leading cause of infant death. In fact, according to the March of Dimes, one in 10 babies are born prematurely in the United States each year. Some women are starting to hear more emphasis placed on the risk factors associated with preterm birth when they visit local hospitals and doctors’ offices. It is part of a new initiative to reduce premature births by identifying and educating pregnant women who are at an increased risk.

“Premature births lead to very serious consequences for mom and baby,” says Luis Castro, MD, Medical Director at St. Joseph’s Health’s Primary Care Center West. “They are also a huge burden on the healthcare system.”

Led by St. Joseph’s Health, with funding through the CNY Care Collaborative, this initiative was first developed in late 2017 and has recently received $250,000 in renewed funding to expand its reach across Central New York.

Participating hospitals and outpatient prenatal care providers receive technical support to update their EMRs with prompts and data collection fields for information related to four categories of risk factors for pregnant women, including:

  • Tobacco use
  • Alcohol use and substance abuse
  • Stress management
  • Oral health

“Many patients never get to the OB/GYN until the second trimester when significant organogenesis has already occurred,” says Regina Farrell, MD, an obstetrics and gynecology specialist at St. Joseph’s Health. “Therefore, it is important for other medical providers to be aware and use the prompts to help patients optimize their health and give them the best chances for a successful pregnancy.”

“The education is going very well,” Dr. Castro says. “Many first-time teenage moms are surprised to learn of the risk factors. Once we identify them, we are able to provide assistance.”

This is the first time many healthcare organizations are using prompts in patients’ EMRs to identify these risk factors, and all at once. This allows doctors to immediately address the issue or refer the patient to another specialist. The physician then updates the patient’s information across the entire system for the clinic or hospital. The team at St. Joseph’s Health will also receive the data to track and report the success of the initiative.

Patient educational materials are provided for the clinicians to give to patients so as to increase their awareness of the potential negative effects that these risk factors can have on their unborn baby.

“It is nice to work with patients in a systematic fashion to help them understand all the available resources offered by St. Joseph’s Health and the community, and how they can contribute to a healthy pregnancy, mother and baby,” Dr. Farrell says.

As a result of the screening, patients are already utilizing other important services at St. Joseph’s Health, according to Dr. Farrell.

“Patients are now accepting and understanding their role in a healthy delivery because we are helping them get to appointments,” Dr. Farrell says. “They’re taking advantage of individual and group counseling, smoking cessation assistance, our dental clinic and other services they may need.”

“Babies born prematurely may face serious health problems. This enhancement to electronic health records will help ensure that at-risk patients are receiving the appropriate screenings, assessments and referrals for follow-up care as necessary,” says Sandra Sulik, MD, Medical Director of Primary Care Services at St. Joseph’s Health. “St. Joseph’s Health is also providing staff for hospitals and organizations for ongoing education to further enhance the positive impact of the tools that are being implemented.”

In Onondaga and surrounding counties, other hospitals, outpatient practices, obstetricians’ offices and private midwiferies are also in talks with St. Joseph’s Health to join the program. In addition, the Onondaga County Health Department, the CNY Regional Perinatal Program, local pharmacies, insurance offices and other community-based organizations display posters and provide other information to raise awareness of this important initiative.

“Local healthcare organizations are welcome to contact St. Joseph’s Health to participate,” Dr. Sulik says. “It doesn’t need to be an OB practice. Primary care practices, dental offices and other organizations that provide healthcare services to pregnant women are all eligible to join.”

The team at St. Joseph’s Health will receive the data to track and report the success of this initiative. While it will be months before significant data from this new effort can be analyzed, St. Joseph’s Health has already been invited to present this initiative at state and national conferences. This 4di DSRIP project was funded by the Central New York Care Collaborative, as part of the NYS initiatives to reduce Medicaid spending.

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