Successes and Challenges of Implementing Telehealth for Diverse Patient Populations: Attending to Prenatal Care during COVID-19 (Preprint)

BACKGROUND While telehealth appears to have been accepted among some obstetric populations before the pandemic, patients’ receptivity and experience with the rapid conversion of this mode of healthcare delivery is unknown. In this study, we examine patients' prenatal care needs, preferences, and experiences during the COVID-19 pandemic. OBJECTIVE To examine patients' prenatal care needs, preferences, and experiences during the COVID-19 pandemic, with the aim of supporting the development of successful models to serve the needs of pregnant patients, obstetric providers, and healthcare systems during this time. METHODS This study involved qualitative methods to explore pregnant patients’ experiences with prenatal healthcare delivery at the onset of the COVID-19 pandemic. We conducted in-depth interviews with pregnant patients in the 1st and 2nd trimester of pregnancy who received prenatal care in Cleveland, Ohio from May to July 2020. An interview guide probed experiences with healthcare delivery as it rapidly evolved at the onset of the pandemic. RESULTS While advantages of telehealth were noted, there were several concerns noted with the broad implementation of telehealth for prenatal care during the pandemic. This included concerns about monitoring the pregnancy at home, the need for additional reassurance for the pregnancy given the uncertainties presented by the pandemic, and the ability to have effective patient-provider discussions via a telehealth visit. The need to tailor telehealth to prenatal healthcare delivery was noted. CONCLUSIONS Although previous studies have demonstrated telehealth is a flexible and convenient alternative for some prenatal appointments, our study suggests that there may be specific needs and concerns among the diverse patient groups using this modality during the pandemic. More research is needed to understand patients' experiences with telehealth during the pandemic and develop approaches that are responsive to the needs and preferences of patients.