The federal Well being Sources and Companies Administration funds state-level work to handle excessive ranges of maternal mortality in the US and to scale back disparities in maternal and start outcomes. In Maryland, Andreea Creanga, M.D., Ph.D., chair of the Division of Epidemiology and Public Well being on the College of Maryland College of Medication, leads the Maryland Maternal Well being Innovation Program (MDMOM)a $15.8 million HRSA-funded program that drives innovation in information assortment, high quality enchancment, workforce improvement, and group engagement throughout the 32 birthing hospitals in Maryland. She lately spoke with Healthcare Innovation about her group’s work.
Creanga’s group works to develop, implement and consider statewide initiatives aiming to remove preventable maternal deaths and extreme maternal morbidity within the state of Maryland.
Nationally, Creanga serves as principal investigator of the Maternal Well being Information Innovation and Coordination Hub, a nationwide useful resource that helps 12 NIH-funded Maternal Well being Analysis Facilities of Excellence.
Healthcare Innovation: I hoped you can set the stage by speaking in regards to the scope of the issue of moms dying of preventable causes in Maryland and the racial disparities concerned.
Department: Maternal mortality has been rising in the US. Throughout the nation, we’ve got seen a marked improve in maternal deaths for the reason that early 2000s. We are able to debate whether or not we’re doing a greater job detecting maternal deaths, as a result of we’ve got made a few modifications on the dying certificates. We’ve got a being pregnant checkbox that may be checked if the deceased was pregnant or postpartum. With that, we predict we’re capturing extra of the maternal deaths, however in all probability nonetheless not all.
We additionally know nationwide and in Maryland, we’ve got notable disparities in each maternal mortality and likewise different adversarial occasions in maternal well being and adversarial being pregnant outcomes. We all know that the disparities have continued over the previous 30 years. That is vital. The excellent news is that in Maryland and nationwide as properly, about 80% of maternal deaths have been proven to be preventable. Well being system and group elements play a job. We all know what’s working in maternal well being. We all know which interventions are life-saving.
However the metaphor we at all times use in maternal well being is that that is simply the tip of the iceberg. Under that’s extreme maternal morbidity. These are close to misses — ladies who nearly died however survived the complication of being pregnant resulting from interventions in hospitals or via the well being system, or interventions in communities or by sufferers themselves. We’ve got in all probability between 50 and 60 occasions extra extreme maternal morbidity occasions than we’ve got maternal deaths. That is why we need to examine them in tandem.
HCI: What’s the Maryland Maternal Well being Process Pressure and what’s its relationship to your MDMOM program?
Department: The MDMOM program is definitely the Maryland Maternal Well being Innovation Program. We’re one of many 42 states and the District of Columbia funded for this sort of work by HRSA. Our focus is statewide. We truly began this work by establishing a Maternal Well being Process Pressure within the state. We convey collectively colleagues from hospitals, group members, community-based organizations, skilled organizations, and well being businesses. We meet quarterly with the duty pressure, and we’ve got already put collectively two strategic plans for the state. The newest one was performed in September 2025 for the following 5 years.
We are actually working in direction of delivering on the ways and interventions which have been proposed in within the strategic plan.
HCI: Is there any type of networking that takes place among the many state-level teams themselves to share finest practices or classes discovered?
Department: Undoubtedly. HRSA brings us collectively a few occasions per 12 months. We do have a little bit of a useful resource hub that interacts with all of the states, they usually present sources throughout this system for the entire states.
HCI: You talked about earlier than that by way of interventions, we all know what works to decrease maternal mortality. So if we seemed throughout the applications throughout the nation, would they be doing fairly comparable issues, or are there folks attempting to assume outdoors the field on issues that possibly do not have proof for them but, however they’re attempting to display a brand new type of intervention?
Department: So by and huge, we all know what works, and we’ve got the skilled organizations which have proposed affected person security bundles. All types of collaboratives throughout the hospitals work to handle sure key causes of maternal mortality and morbidity. However that is referred to as the Maternal Well being Innovation Program, in order a part of the proposal, the applying truly needed to embody improvements. They could possibly be improvements in how we gather information, how we have a look at information, how we overview data, or particular applications which might be revolutionary, like telehealth initiatives.
HCI: May you speak in regards to the hospital initiative and the way it works to enhance techniques of care in Maryland hospitals? Do you get participation from all or many of the birthing hospitals within the state?
Department: Initially, we began with a surveillance program. Surveillance is simply monitoring of extreme maternal morbidity occasions to determine all of them, attempting to gather and overview the information in the identical method throughout the hospitals.
We began with a pilot of six hospitals again in July 2020 and now we do have all of the hospitals taking part on this surveillance system. In Maryland, we have been in a position to advocate for and go laws in 2025 to convey all of the hospitals to this undertaking. We’ve got 32 birthing hospitals within the state. We had 27 of them voluntarily taking part. We had 5 extra that we needed to by some means push. The laws did the trick. For the primary time, we have been in a position to submit a statewide report back to the governor’s workplace in December 2025 and that was actually well-received by all of our companions.
HCI: Are there applications that go into the hospitals to handle issues like bias coaching?
Department: Sure, with the primary grant that we had from HRSA, we have been in a position to supply implicit bias trainings to suppliers. On the time there was just one coaching that was devoted to perinatal well being suppliers within the nation. It was developed by the March of Dimes. So we truly bought licenses for that have been in a position to prepare about 4,000 perinatal well being suppliers within the state of Maryland with that coaching. Constructing on that, we developed our personal supplies and skill-building workouts and movies about learn how to speak to your sufferers and the way to not speak to your sufferers.
We reached plenty of perinatal well being suppliers and to create consciousness round implicit bias, as a result of that is step one.
HCI: May you discuss your telehealth initiative round extreme hypertension in being pregnant?
Department: We began in Could 2022 with attempting to supply professional maternal medication recommendation help from College of Maryland Medical Middle to the lower-level hospitals that have been a part of the College of Maryland Medical System. Our suppliers right here at College of Maryland Medical Middle have been credentialed to supply telehealth help, professional recommendation to their sister hospitals within the system.
Then the Maryland Perinatal Neonatal High quality Collaborative determined to implement statewide the extreme hypertension bundle from ACOG (American School of Obstetricians and Gynecologists). Due to that, we noticed a possibility to help them, and we began the second a part of the telehealth initiative, which is distribution of free blood stress cuffs with Bluetooth to allow them to be built-in into the EHR. The thought was to place this sort of gadget into the palms of sufferers, in order that they’ll examine their blood stress at house, and alert their suppliers if there are irregular blood stress readings. And we hope that this initiative is definitely going to enhance the follow-up, and sufferers are going to be seen quicker. We’re at the moment distributing between 13 and 15 blood stress cuffs per day. We work with 29 of the 32 hospitals for this initiative, and that is as a result of the opposite three hospitals produce other technique of offering the blood stress cuffs to their sufferers.
We evaluated this system within the fall of 2025 and we are actually analyzing the information. We talked to all of the hospitals which might be a part of the initiative, and we have discovered fairly a bit from them, as a result of each single certainly one of them did issues another way. So we’re studying what labored finest for them, after which attempting to share the learnings throughout the initiative.
HCI: I learn that your group created a Maryland Maternal Well being Sources Map. What sort of sources are on the map and the way would households use it?
Department: We’re very pleased with it. This was a spot recognized by the duty pressure initially, and we have been requested to help the event of the map.
We began very small. We initially thought that we’d simply be excited by hospital-based or clinic-based companies. Then we realized that the wants are higher, so we began to take a look at social companies — training, birthing courses, issues like that. Then we found the 211 useful resource. If you happen to go to mdmomresources.org, you may see the classes that we’ve got, beginning with reproductive well being companies, maternal well being companies, postpartum companies, and likewise social companies. We’ve got the whole lot organized round 28 classes of companies, and all collectively, we’ve got greater than 2,600 companies accessible. I do not assume our moms, our sufferers, truly know what number of companies can be found to them and the place to search out them. With a map, you truly are in a position to determine these sources in your group, very near your own home, very near the hospital the place you are going to give start, in order that you’ll be able to get the helps that you simply want.
It is also an excellent software for suppliers, as a result of many occasions sufferers ask suppliers the place ought to I’m going for that? And suppliers didn’t have a repository prior to now, so now they’re utilizing the map themselves.
