Remote Obstetrics: There's an app for that?!
Tuesday, August 10, 2010 at 8:50AM
AirStrip OB was developed to improve the speed and quality of communication in healthcare, citing the Joint Commission’s claim that ineffective communication is a leading cause of medical errors leading to patient injury and noting that “preventable healthcare related errors cost the U.S. economy $17 to $29 billion each year.” The application sends “critical patient information” to a doctor or nurse’s (midwives not mentioned) smart phone, laptop or desktop, which gives “obstetricians remote access to live views of delivery room data — including fetal heart tracings, contraction patterns, vital statistics and nursing notes.” Even though the information is access remotely on mobile devices, the site claims that the app is HIPAA-compliant.
Offered as a success story on the AirStrip OB corporate website is an article in the St. Petersburg Times in which a physician at Community Hospital, which has a 37.7% cesarean rate, was able to see 30 patients in the office while “keep[ing] tabs” on a patient whose induction began at 5 a.m. that day. The doctor “saw a slight fluctuation in [the baby]’s heartbeat that told him the baby wouldn’t be able to withstand a long labor.” He performed a cesarean on the woman at about 1 p.m. and ushered a “healthy 8 pound, 14 ounce girl” into the world.
The page of testimonials features cheers from physicians, one of whom says, ‘At least with AirStrip OB, I can minimize unnecessary trips to the hospital.” Another raves, “But the greatest aid of all is that I can check the strip in real time when a nurse calls and reports concerns…I just open up AirStrip OB on my iPhone, review the strip and discuss the situation with the nurse…Medicolegally, I expect that this ability will not only benefit the obstetrician, but the hospital as well.”
And if the baby is not doing well? Then what?
One of the misunderstandings that many patients have about giving birth in a hospital is that a doctor will be right there, ready to perform a crash cesarean section or operative delivery at the drop of a hat if their baby is experiencing severe fetal distress. But keeping these resources available around the clock is extremely costly and in the name of efficiency and profitability, most hospitals fall far short of this supposed ideal. Even in hospitals that do have 24/7 surgical and anesthesia coverage, if they are performing another cesarean, the surgical suite and necessary staff may not be immediately available when an urgent complication develops.
The following guest post was submitted by Amity Reed in reaction to reading about the distancing “benefits” of the AirStrip OB application in an article.
Have you ever been laboring hard in the hospital — attached to all the various wires and machines; surrounded by equipment, instruments and alarms — and thought: how can we upgrade this birth from merely medicalized to hardcore hi-tech? Well, your prayers have been answered, ladies! The latest in baby removal technology allows your OB to take in a movie across town and simultaneously manage your birth. Soon, doctors may not even have to step foot in hospitals in order to do their jobs. This is the wave of the future: taking people out of the care equation altogether!
Yes, my friends, you too can now have major decisions about your maternal care made by any doctor with the latest smartphone application. Called ‘AirStrip OB’, this app delivers (ha!) real-time information about a woman’s labor so that busy doctors can make judgment calls about women they’ve not witnessed in labor (or even met!) from the comfort of their home. No more worries about wasting a highly-educated obstetrician’s time with your piddling requests for mobility, sustenance or support; the AirStrip OB app reduces the embarrassing tendency of patients to ask questions or expect personable care. ‘Emergency’ cesareans can now be ordered and performed before your OB’s sedan has been sufficiently warmed and gone through the Starbucks drive-thru. Technology is amazing, isn’t it? As those of us in the baby removal business like to say: “If you’re not in the room, cut open that womb!”
With this cutting-edge (ha!) technology, it’s never been easier to imagine c-section rates approaching 50 or even 60%. Soon, the use of vaginas for delivering babies will be obsolete altogether, leaving women with fresh, modern ‘love tunnels’ free from the wear and tear of childbirth. No more expensive vaginal rejuvenation surgery or labia lifts! Our technology, with its resulting seven-fold decrease in normal births, maximizes your chance of avoiding dangerous and unsightly vaginal birth.
But, wait, that’s not all! A recent survey found that 85% of the births portrayed on television and in films left fathers-to-be feeling disgusted, terrified and excluded. Everyone knows childbirth is pretty heinous and yucky, am I right? With the AirStrip OB app, you give your partner the gift of feeling secure in his masculinity, allowing him to renew his claim on your vagina. Why have a ghastly ‘husband stitch’ on your perineum when you can have a simple ‘husband staple’ on your tummy? Nothing says ‘I love you’ like abdominal surgery!
We hope all pregnant women come to know and love the AirStrip OB application, as all good mothers should. You don’t want to be one of those mothers who takes her chances for selfish reasons and ends up with a dead baby, now do you?
Look for another of our exciting apps coming soon, in which a Blackberry-controlled robot does all of your prenatal care. His hands might be a little cold but it sure does help your OB get to her dinner table on time! After all, isn’t that what we all want?
Amity Reed is a news junkie, feminist, birth activist and doula living in London with her husband and two children. She blogs at Noble Savage and Fertile Feminism, has three Twitter accounts and two work-at-home jobs. Her favorite activities are multi-tasking and drinking wine.
Reader Comments (23)
I cannot even believe this is real. This make the Python 'machine that goes ping' sketch look positively normal and nurturing. Hold me.
GREAT. I had read about this new app and was partly disgusted and partly intrigued.
I was at a birth a month ago where the OB came in and said, "I was watching your strip from the office and was thinking it was time to start pit."
I was surprised she could see the strips at her office, but maybe she had this new cool APP? Or do OBs have strip readouts in their office too? At least she came in to talk to her patient instead of just telling the nurse to do it. (Mom didn't say yes to pit BTW, she said, "Let's wait another hour or so." )
I can see why OBs would love it, but I can also see how this just separates them from birthing women even more! Which is so very sad for the women, who deserve more personalized care.
Yes I think this will be very popular for many OBs. It's really sad, though. Although it will probably have to be taken off the market after someone sues because their baby dies because the OB wasn't in the hospital.
"Have you ever been laboring hard in the hospital — attached to all the various wires and machines; surrounded by equipment, instruments and alarms — and thought: how can we upgrade this birth from merely medicalized to hardcore hi-tech? Well, your prayers have been answered, ladies!"
Bwahahaha! Really a nice gift for the OB in your family, though. You know, something portable for the golf course?
OMGoddess, just another way to make OB's less a part of the birthing process, have the nurses do everything else, and just come in to catch the baby.... I tell you something if you are that uninterested in the birthing process.... DO SOMETHING ELSE WITH YOUR LIFE!!!! and leave birth to whom it belongs.... Mothers....
(well maybe the Odd OB here and there for the actual really needed C sections but otherwise....)
Thanks for the big laugh! XD
Came across this quote from a news article: "I was snowboarding in Utah and I was curious if one of my patients had gone into labor and delivery," Loar said. She was able to access the information from the slopes, scrolling through data the same way you might flick your finger across a list of songs and zooming in on a chart as you might do with a photo on an iPhone screen."
Wow. Not only does it prevent unnecessary trips to the hospital for these OBs, but it allows them to take all the vacations they want. Let the nurses and PAs do prenatals, check your app, and show up just to catch and pass off.
ROFL at "If you're not in the room, cut open that womb" and "Nothing says 'I love you' like abdominal surgery."
Ooooorrrrr, you could just get a home-birth midwife, and actually have the birth attendant and care provider with you *in person* rather than across town.... Nah, that'll never catch on!
This is so awful and sad. It's an advancement in maternity care, but certainly not for the better.
BUT, (and there's always one, right?) it makes me wonder if this would qualify for that "immediately available" clause in the VBAC recommendations?
Oh, Kathy. You and your wacky idea of a 1-to-1 provider-patient ratio. Two-to-one if you include the birth assistant.
Besides being very sparkly and cool, there must be some way this is great for a tech-savvy OB or CNM who is on-site.
I guess they could keep track of the strip while grabbing a coffee or taking a bathroom break? Since you know how with birth, all hell can break loose in .2 seconds....
To play devil's advocate, it seems like this could prevent as many abuses as it might cause. While I love my midwifery care and the wonderful ratio of continuously present caregivers to patients, most patients are currently being cared for by OBs who won't make an appearance until close to the delivery. I know it can be difficult to communicate all the subtleties of an EFM strip (as you can tell from the continual redefining of standard ways to communicate and document this info). If an OB has to come in to the hospital to review a strip (interrupting sleep, a day of patients in the clinic, etc.), might he/she be MORE likely to intervene in order to avoid having to come back than if he/she could review the strip and decide it was reassuring enough without coming into the hospital. It seems like this technology might do nothing but harm in an ideal world, but I think it has the potential to do some good in the world as it is.
Also makes me wonder how this will relate to patient confidentiality... especilally Amber's comment that mentioned flicking through to review patient chart info on the slopes... all seems a little less than "secure" from a confidentiality standpoint!
Onnnnnn the other hand. . . what if this counts as having an OB "available," in the case of states that require midwives to practice along with an OB? Could this actually improve access to midwife-driven care?
Christie, that is an excellent point about being able to actually SEE the monitor as opposed to hearing it verbally relayed at 3 a.m.
Kathryn, I don't know. I'll run it past a friend and see what they say.
I don't know whether to laugh or cry (okay, I confess, I lol'd). Just had a talk with my mother about choosing to not go to a hospital for my next. That was quite an adventure. She suggested I get life insurance for when I die in child birth (yeah, went over that well). Maybe she'd change her tune if she realized how unavailable an OB really is, compared to a midwife who's with you the whole time, and not making critical medical decisions from a blackberry app in a movie theater, accessing a monitor that's only accurate about 20% of the time. *sigh*