@louise_weile

Using algorithms and patient data for identification of special needs in antenatal careLOUISE KATRINE KJÆR WEILEPhD student, Midwife, MHSc.Dept. of Obstetrics & Gynaecology, Odense University Hospital

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Individualization of antenatal care

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• At pregnancy recognition, the

woman seeks GP,

• GP records medical history and

refers the woman to a birth

facility, and

• Birth facility makes a

personalized plan for antenatal

care program.

Problems to individualization of antalnatal care

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Problems to individualization of antenatal care

• GP reports under time constraints, and

• The procedure is not systematically conducted, entailing:

– Clinicians need elaboration of the medical history,

– Neglect of non-medical aspects,

– Late identification of special needs.

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Problems to individualization of antenatal care

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Solution 1.0

• We developed a digital solution to collect information by self-report

• Include the patient’s perspective, and overcome clinical time constraints.

• We integrated algorithms to extract ‘the essence’ of the

(overwhelming amount of) self-reported information:

• Generation of a resume (only including relevant information),

• Screening for factors indicating special needs according to

recommendations/guidelines (triggers).

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Solution 1.0

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Interface: planners

Special needs

Search patient

Create List patients Family Clinic

Condition

Drugs

Violence

Cervical surgery

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• Implemented December, 2017

• So far >7,700 records created

• Response rate: 90%

Evaluation: Solution 1.0

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Evaluation: Solution 1.0

We now identify all women with

risk factors for gestational

diabetes vs. GP: 50% (sample:

n=100)

~1,800 cases referred to OGTT before the

clinical meeting with the woman

Survey among midwives

(response rate 65%)

• 100% base the first meeting with the

patient on information in the resume,

• 93% agree that the resume gives

additional, relevant information not

reported in the referral from GP.

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Evaluation: Solution 1.0

• 4 levels of care according to the Danish Health Authority

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Development: Solution 2.0

Special needs

Condition

Drugs

Violence

Cervical surgery

Special needs

Drugs

Violence

Cervical surgery

Level 3

Level 4

Version 2.0

Condition

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Development: Solution 2.0

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Development: Solution 2.0

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Development: Solution 2.0

Search patient

Create List patients Family Clinic

Special needs

Drugs

Violence

Cervical surgery

Level 3

Level 4

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Individualization of antenatal care

Thank you!

LOUISE KATRINE KJÆR WEILEPhD student, Midwife, MHSc.Dept. of Gynaecology & Obstetrics, Odense University Hospital

@louise_weile