Mayo Clinic’s do-it-yourself experiment shows another way health care is changing under the pressure of reform.
On the morning of her doctor appointment, Andrea Pedersen had stopped at the gym to check her weight and blood pressure. She noted her measurements on her iPhone, and at the appointed time, she headed to a computer for a video chat with her physician.
Altogether, she admits, it wasn’t the typical prenatal visit.
But it may be by the time her 7-month-old daughter, Anna, grows up.
Pedersen, who lives in Rochester, was taking part in an experiment at the Mayo Clinic to test a new do-it-yourself model of prenatal care.
And while it’s not yet ready for prime time, experts say it’s one more sign of how the pressure to reform health care, and rein in costs, is starting to transform modern medicine. The experiment is one of several taking place at Mayo’s Center for Innovation, a breeding ground for new ideas.
Maternity care seemed particularly ripe for change, according to Mayo’s own surveys, said Marnie Meylor, one of the project leaders. “This is a very tech-savvy population,” she said. Young women, armed with smartphones, are used to getting information fast and at their convenience.
Yet the current model of prenatal care — which revolves around a fixed schedule of office visits — “was developed about the same time the telephone was invented,” said Dr. Roger Harms, a Mayo obstetrician. “It hasn’t changed much since.” And he thinks it’s overdue. For the most part, Harms said, prenatal care is about two things: monitoring the baby’s progress and making sure the mother is healthy.
So he and his colleagues started wondering: If women could do more of the monitoring themselves, would they be able to reduce costs and possibly improve care?
A series of experiments, known as OB Nest project, was born.
Harms and his team started enrolling pregnant volunteers, giving them special phone apps and other equipment to track their vital signs at home. They even installed fetal monitors at kiosks around the Mayo Clinic campus, where participants — many of them Mayo employees — could listen to their babies’ heartbeats on the way to lunch.
The expectant mothers were told they could contact the clinic, night or day, any way they preferred: phone, e-mail, text.
Jewel Wang, 27, jumped at the chance. At the time, she was pregnant with her second child and heading to Shanghai to join her husband for several months.
“I would have had doubts if it was my first pregnancy,” she admitted. But in this case, she said, “it worked out fantastically.”
Once a week, she took her own vital signs, measured her abdomen and used an iPhone app to snap pictures of her growing belly.
All in all, she said, it was “hard to mess up.” She sent in her results electronically to the Mayo team and followed up with e-mails and the occasional “face to face” doctor visit on Skype.
Ordinarily, Wang would have visited her obstetrician once a month during her second trimester. But remembering her first pregnancy, she didn’t feel she was missing much. “It was just hand-holding and making sure I was OK,” she said.
‘It was just reassurance’