The Northwell Health Pregnancy Chat is a new tool in Northwell’s campaign to reduce the country’s maternal mortality rate — the highest in the industrialized world.
Northwell Health announced the rollout of Northwell Health Pregnancy Chats to obstetrics practices throughout the health system. An artificial intelligence-driven pregnancy chatbot, the customized, conversational platform is a key tool in Northwell’s high-tech and high-touch campaign to reduce maternal morbidity and mortality. The United States has the highest rates of those problems of any of the world’s industrialized nations.
The chatbot is both an educational program and a virtual safety net that can identify urgent concerns and ensure speedy help for women during and after pregnancy. It offers weekly informational dialogs that are based on the stage of pregnancy and personalized according to a patient’s self-reported risk factors. Many of the chat’s questions are designed to help patients notice subtle changes sooner than they otherwise might have, which can lead to earlier detection if complications are developing.
The chatbot links seamlessly with a Northwell care management team, enabling prompt escalation to in-person clinical care if a patient’s responses indicate a potentially serious issue, generally directing the patient to connect with her provider. “Red flag” responses trigger an immediate call from a care navigator at Northwell Health Solutions, the health system’s care management arm — or, in some cases, instructions to call 911 or go to the nearest emergency department.
A pilot program at a Northwell obstetric practice showed the tool to be effective. The chatbot was used by 1,632 patients, 96% of whom reported being satisfied or somewhat satisfied with the experience. Critically, the chatbot successfully identified urgent health problems in a handful of users. One woman whose red-flag responses regarding blood pressure prompted a message to call 911 was found to have severe preeclampsia requiring hospitalization. (Preeclampsia is a serious condition involving high blood pressure during pregnancy and can be fatal if not treated.) In another case, during an automated new-parent chat, a woman shared that she had experienced thoughts of harming herself; she reported that she had not shared her symptoms with her provider but felt comfortable acknowledging them to the chatbot because of the feeling of anonymity. The care team reached out immediately and within 24 hours was able to connect the patient with a psychiatrist and other mental health support.
“Northwell Health Pregnancy Chats are both extremely comprehensive and highly individualized and are designed to complement the interactions patients have with their providers,” said Michael Nimaroff, MD, senior vice president of Northwell’s OB/GYN service line and chair of Obstetrics and Gynecology for North Shore University Hospital and Long Island Jewish Medical Center. “It’s a way to ensure women are never without support, whether they’re in a doctor’s office or in their own home.”
The Northwell Health Pregnancy Chats were developed in conjunction with Conversa Health (part of Amwell), a leader in providing automated virtual health. Spanning pregnancy and the first year postpartum, the chats include a health risk assessment and cover maternal and fetal changes throughout pregnancy, blood pressure tracking, prenatal testing, birth plans, lactation support and more. The chatbot will eventually be offered to women receiving pregnancy care at clinics and OB practices throughout Northwell’s catchment area. Sign-up is at no cost to the patient, and chats can be accessed on a patient’s smartphone, tablet or computer.
The tool is an important step in Northwell’s initiative to reduce the country’s maternal mortality rate. In the U.S., 26 out of 100,000 women die during childbirth, compared to 4 out of 100,000 in Italy and Denmark and 9 out of 100,000 in the United Kingdom. The risk is particularly extreme for Black women in the U.S., who are three times more likely than white women to die from pregnancy-related causes. Last year, Northwell launched its Center for Maternal Health to address these risks through a multitude of programs, focusing both on hospital care and community-based wellness efforts.
“Far too many pregnant and birthing people in this country suffer harm or even die because of problems that are entirely preventable. Northwell is committed to doing whatever is necessary to reduce those risks,” said Dawnette Lewis, MD, MPH, director of the Center for Maternal Health. “By bringing together high-tech innovation and high-touch clinical care, the Northwell Health Pregnancy Chats will help keep women and babies safe.”