ROAMS (Rural OB Access & Maternal Service)

Description

In northeastern New Mexico, many patients face barriers to maternal health including poverty, long drives to appointments, and local providers unable to care for high-risk pregnancies. To improve maternal health, Holy Cross Medical Center in Taos, Miners Colfax Medical Center in Raton, and Union County General Hospital (UCGH) in Clayton created the ROAMS (Rural OB Access & Maternal Service) program. ROAMS provides obstetric and maternal fetal medicine telehealth, home telehealth kits, and free access to lactation consultants and family navigators.

ROAMS serves the following rural counties:

• Colfax
• Harding
• Mora
• Taos
• Union

ROAMS received a 2019-2023 Federal Office of Rural Health Policy (FORHP) Rural Maternity and Obstetrics Management Strategies (RMOMS) grant and is currently funded by the Brindle Foundation, the Con Alma Health Foundation, and the Managed Care Organization Reinvestment Fund through the state's Medicaid program.

Services offered

Patients can use telemedicine to connect with obstetricians (OBs), and those with high-risk pregnancies can connect to maternal fetal medicine (MFM) providers in Santa Fe or Albuquerque.

ROAMS patients can receive a home telehealth kit that allows them to complete telehealth appointments at home and measure vital signs like blood pressure and fetal heart rate. Patients can also receive texts with information and appointment reminders during their pregnancies and postpartum.

Patients can meet with lactation consultants and with family navigators/community health workers to address social determinants of health like transportation or food insecurity.

Results

UCGH Health Clinic facilitated 108 tele-OB appointments, saving patients a total of 18,360 miles and 324 hours of driving.

From September 2019 to August 2020, 41% of expectant mothers at Miners Colfax Medical Center did not have a prenatal exam in the first trimester. From 2020 to 2021, that number went down to 36% and then dropped to 25% the following year.

Challenges

It was challenging to establish partnerships between medical organizations that share patients but don't usually collaborate.

Sustaining a tele-OB program can be a challenge since many rural hospitals lose money by providing OB services and don't want to split the billing with another site through tele-OB.

Replication

Rural locations receiving tele-MFM services need a high-quality ultrasound and a trained sonographer. Tele-MFM is more complicated and expensive to implement than tele-OB, but it does have a sustainability mechanism of billing separate for a specialty visit.

Tele-OB is relatively easier to implement than tele-MFM, since it does not require as much technology or staff training.

Contact Information

Colleen Durocher, Executive Director
ROAMS
CDurocher@TaosHospital.org