Maternal and child health are critical for digital solutions that positively impact pregnancy outcomes. As early as 2016, this category of app saw approximately 200 million downloads as the broader consumer marketplace looked to smartphone trackers for fertility and maternity education.

While the COVID-19 pandemic has added an additional reason to have care online that avoids an in-person gynecologist office visit for a physical check-up, these apps should be reviewed for utility, features and effectiveness in patient education, emotional support, engagement and awareness.

Why fertility health apps are useful

In the current COVID-19 environment, both consumers and employers are seeking maternal health solutions that provide a comprehensive and integrated end-to-end solution that supports conception, pregnancy, delivery, postpartum recovery, lactation, and early childhood development with additional resources for infertility, adoption and surrogacy.

A generation that grew up with technology is starting families, and those who were more reluctant to embrace technology in healthcare are pivoting to more acceptance. In addition to conception, the FDA approved the first direct-to-consumer app for contraception in 2018. This app uses an algorithm that takes into account complex factors such as menstrual cycles, sperm survival rates and body temperature to estimate when a woman is ovulating.

Companies have quickly understood how to appeal to the consumer with an integrated, digital-enabled care solution that will support the future parents' journey as a digital-native experience. These tools must address the diversity of potential users. They should adapt to new family structures, and appeal to single parents and LBGTQ.

Fertility health apps and companies that provide them

Based on correct and consistent daily input of data, most apps provide an estimate of when a woman will have fertile days. In many cases, these apps offer not only a tracking process, but also education specific to niche maternal health needs and care-management advocacy to support them. 

This data is also invaluable, both to the company valuation that holds the information and also to the consumer that can have more customized and personalized solutions based on the data collected.

In 2018, a few payers launched a national, value-based-care maternity-bundled payment model for commercial group members with low to moderate risk pregnancies. Since then, more employers began to provide programs that enable expecting parents to connect to resources and tools such as health alerts and reminders, cost and quality tools, maternity coaching, provider locators and the ability to call a nurse 24/7.

Three general categories of apps exist:

• Tracking ovulation and fertility.
• Providing comprehensive pregnancy solutions with personalized content and access to nurses and specialists.
• Access to specialized solutions for navigating ART (assisted reproductive technology) or manage care coordination.

Although different in scope, they all provide engaging experiences that match the expectations of digital consumers. Their platforms have demonstrated that maternal health does benefit from digital programs that enable improved outcomes with high net promoter scores.

Moreover, these digital platforms support women transitioning from conception to pregnancy, and pregnancy into parenting, with an engaging interface across the multiple phases of the process. Some programs even focus on high-risk pregnancies for useful guides and navigation tools.

Companies are investing in demonstrating their impact and in optimizing capabilities to impact key metrics with measurable financial outcomes for employers, such as reduction in C-section rates, a lower use of ART, lower rates of births requiring intensive neonatal care and improving the transitional experience of returning to work.

Integrated digital platforms are key

The key for successful engagement is an integrated portfolio of tools and services focused on supporting the potential parent across fertility, pregnancy and post-partum. Several companies have developed applications that serve the initial scope of fertility-tracking and, once this milestone is achieved, that adjust to pregnancy by carrying over the information and preferences from prior times into pregnancy. This transition is made possible by key concepts such as:

• Digital screeners to monitor symptoms from conditions such as preeclampsia during pregnancy (headaches, vision changes and nausea) or postpartum depression after pregnancy.
• Identifying root cause issues (lack of nutrition or increased stress) and combining them with evidence-based options, education and interventions to help increase the probability of natural conception and delivery.
• Digital tools to encompass context-specific digital education (knowledge, attitudes and beliefs) and dynamic content that engages users in a timely and relevant fashion;
• Self-service engagement with the digital platform that minimizes the user’s efforts, such as asking questions only in the specific context by leveraging prior inputs.
• LGTBQ inclusion by providing programs capable of adapting to the needs of same-sex couples seeking to work with a surrogate, or ones that help same-sex female coverage in a member plan to give access to fertility and pregnancy care benefits.
• Cultural flexibility by providing dynamic and robust content that can specifically address traditions and cultural practices relevant to future parents of all backgrounds and cultures. This includes content recognizing and speaking to the importance of different family structures and their caregivers.
• Provide digestible content accommodating all levels of health literacy and language abilities (such as Spanish-speaking only). Content should be designed to be approachable and understandable for various reading levels.
• Integration between clinical and service operations of the health plan. This includes care-management services and providers for high-risk members who offer digital tools that enable early identification and interaction of users with both service-experience support and digital support.
• Ensure assistance through virtual networks for members living in provider deserts or members who lack reliable transportation. This type of network must provide a unique opportunity to confirm and treat postpartum depression seamlessly for the full length of time that a woman is vulnerable to PPD.

Conclusion

These digital fertility and maternal health apps continue to provide valuable support to women and aim to improve key maternal health metrics such as ART, C-section and neonatal ICU rates. Indeed, these platforms continue to require the correct and consistent input of data to curate accurate solutions. They cannot entirely replace the connection between a trusted clinical provider and a patient. However, they can be used to extend the care in the complexity of our healthcare system with an integrated approach.

About the author: Dr. Liz Kwo is currently the deputy chief clinical officer at Anthem and a faculty lecturer at Harvard Medical School, and previously cofounded and served as CEO of telemedicine second-opinion company InfiniteMD. She received an MD from Harvard Medical School, an MBA from Harvard Business School and an MPH from the Harvard T.H. Chan School of Public Health.