Interview with Mark Rosing, MD, MPH, FACOG, Chair of Obstetrics & Gynecology, SBH Health System
Dr. Mark Rosing received his medical degree and a masters in public health from Columbia University. He’s spent a career focused on patient safety and has led the charge on advancing the delivery of obstetric care through technology. He’s an avid skier and loves a good IPA. And right now, he’s on the front lines of the coronavirus pandemic in New York City.
We asked him a few questions about the state of maternal health during COVID-19, and the role that virtual care is playing to help OBs stem the tide of the pandemic. Here are some of our key takeaways and full video interview.
Click play for full interview, including information on SBH’s “telebirth” initiative, which enables women to have a virtual support system in the hospital room during delivery.
Maternity wards are closing and staff is being reallocated as the situation changes day by day.
More and more units are transitioning to med-surg units as the situation worsens and units are becoming Covid-infected. When the governor or mayor making decisions at the administrative level looks at a labor and delivery unit that needs 40 full time nurses to run, they can't help but see 40 full time nurses that could be keeping Covid patients alive. Human resources are needed to manage inundations from Covid, and that means consolidating other units.
Initial investments in technology are proving indispensable in a COVID world.
We used Babyscripts with great success as a more engaging and accessible solution than complicated and clunky patient portals. We’ve used it in the past to push out information on heat waves and the flu, and now it’s proving essential for updating patients on Covid — not just giving them information about symptoms and changing policies, but also providing them the security of a single trusted resource in the midst of being bombarded with information from all sides. Text, email, and push notifications are helping us keep patients engaged even when not seeing them as often.
Minimizing person to person contact is a priority and virtual care is crucial.
Our first thought was to outpatient care — how do we clear busy waiting rooms and decrease contact with patients and the persons accompanying them? Rescheduling routine appointments is not a sustainable response, so we’ve transitioned to telephone visits and are looking into telehealth options. Fortunately, we’ve been using technology for a while now to amplify care outside of the clinic.
As a resource-poor hospital (about 90% of our patients are on Medicaid or Medicare), we’ve looked to technology to improve efficiencies. We’ve used Trice to send ultrasound pictures directly to patients, and Babyscripts to engage and educate patients outside of the clinic — the virus is making these efficiencies more crucial now than ever.
Talk to payer partners about reimbursements.
Because SBH is resource-poor, we needed to figure out a way to pay for expanding virtual care. We’re now implementing Babyscripts solution for remote blood pressure management that will help us reduce the amount of appointments and keep moms out of the clinic, and we’re working with our major payer to get reimbursement for these tools. Before, I never had the time to meet with the MCO to talk about these things, but everything has been reprioritized, and restrictions are being loosened that make it easier to bring in solutions like remote monitoring and telehealth.
Technology will stay in a post-COVID world.
Healthcare is going to change drastically as a result of all of this, and mostly for the good. Before Covid, a lot of our patients took public transit to get to their appointments, they found childcare or they brought their kids with them, they took time off of work for an appointment — the transition to virtual care that is necessary to keep people healthy and save lives right now is going to save time and money down the line when the crisis has passed. I’m hoping that we can go beyond transitioning to virtual to actually reduce the amount of appointments. Often we’re meeting with patients just to check blood pressure — with remote monitoring of blood pressure that need is removed.