A Country-wide Collaboration to Address the Maternal Health Crisis

After languishing in the background for far too long, the shockingly high rate of complications and deaths related to pregnancy and childbirth in the U.S. is beginning to get serious attention. What’s needed to give new proposals and programs on maternal health the traction they need is data.

A new collaboration, led by the Office on Women’s Health at the Department of Health and Human Services, is taking a data-first approach to this urgent problem. Using a system that captures health information for nearly one-third of U.S. births, the initiative draws on this data to understand care delivery and outcomes. A network of 200 hospitals will then use this intelligence to implement and test solutions in real-world hospital settings.

This network targets hospitals caring for underserved populations, including the health systems we work for, Avera Health (K.M.) and Montefiore Health System (P.S.). Avera serves a 72,000-square-mile territory across South Dakota and neighboring states, with one tertiary care center in Sioux Falls and 15 small hospitals in rural settings. Montefiore is the dominant health care provider in the Bronx, a borough of New York City comprising one of the poorest and most diverse communities in the country.

As documented in a recent Government Accountability Office report, maternity care for rural mothers is particularly worrisome, and more robust data collection is needed for this group. Clinical guidelines tend to be tilted toward care offered in tertiary care centers, which are equipped to provide more advanced treatments. As participants in this cohort, we are eager to augment current best practices and, for instance, collect evidence supporting the best treatment for hemorrhage if platelets — the gold standard — are not available, which is often the case in rural facilities.

HHS, working with Premier, Inc., a health care improvement company that has already done significant work in maternal health, have engineered a data system that integrates standardized information from electronic health records and other data sources with care quality, utilization, and cost information. HHS and Premier automatically pull this data, minimizing error and posing little burden to providers and hospitals, which is essential for meaningful and sustained participation.

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