PodCare: Structured Individual Prenatal Care for the Academic Team [22E]

INTRODUCTION: Innovative models of prenatal care are needed to improve pregnancy outcomes in the U.S, while improving patient and family experience and lowering costs. We sought to improve upon the traditional prenatal model by structuring visits, coordinating care, and training residents within interprofessional teams. METHODS: Attending physicians, resident physicians, associate providers, and clinic staff were split into four “Pods”. Testing and counseling topics were assigned to appropriate visits to create a structured schedule based on gestational age. Weekly Pod meetings provided coordination of care. Data were abstracted retrospectively from Epic for all patients initiating prenatal care in the one year before and after initiation of the new model. RESULTS: 370 of 1084 patients chose the physician-led group in 2014, compared to only 260 of 1064 in 2013 (P < 0.0005), when other care options included CNM and maternal-fetal medicine care. 113 more births were attributed to the Pods, with a total increase of only 48 prenatal visits. The median number of visits per pregnancy decreased, while quality remained excellent and unchanged by standard obstetric measures. Provider continuity with patients improved, and we observed a three-fold increase in the number of patients presenting for postpartum care. Generalist Ob/Gyn physicians also assumed care of more high risk patients under the model. CONCLUSION: The PodCare model is popular with patients, shows promise for improved value by decreasing visits while improving provider continuity and postpartum care, and by providing a robust experience in interprofessional education for residents. Future innovations may include incorporation of formal telehealth visits and biometric sensor data.