accessMedically reviewed by Sina Haeri, MD, MHSA, maternal-fetal medicine physician.
Two categories deserve more room than they usually get: how subspecialty care is delivered, and how systems route patients to it. Telemedicine delivery of maternal-fetal medicine, remote physiologic monitoring, remote ultrasound interpretation, and the levels-of-maternal-care framework are now part of practice for many graduates, and are often taught as footnotes to clinical topics rather than as subjects.
Telemedicine delivery is a clinical skill, not an IT topic
Consulting by video, co-managing with a referring team, and knowing when a virtual assessment is insufficient are learnable skills with their own failure modes. Graduates entering practices that use tele-MFM will do this work whether or not it was taught.
Remote monitoring changes the shape of the data
A continuous stream of home blood pressure or glucose readings is a different clinical input from a reading taken in clinic every few weeks. Interpreting it, and deciding what threshold warrants contact, is worth explicit teaching.
Regionalization and levels of maternal care
Where a patient should deliver, and what a facility at each level is expected to provide, sits behind a large share of transfer and consultation decisions. The current ACOG and SMFM framework is Obstetric Care Consensus No. 9 from 2019, which replaced the 2015 edition that is still widely circulated.
Access as a clinical variable
A large share of maternal-fetal medicine subspecialists practice in metropolitan counties with a Level III perinatal center, which shapes what is realistic for a patient two hours away. Teaching the access constraint alongside the clinical content produces more usable plans.
Where Ouma fits
Ouma's clinicians are board-certified maternal-fetal medicine subspecialists practicing across all 50 states, and the practice publishes on telemedicine delivery of subspecialty obstetric care. We are glad to talk to program directors building this into a curriculum.
Levels of maternal care. Obstetric Care Consensus No. 9. American College of Obstetricians and Gynecologists. Obstet Gynecol 2019;134:e41-55. Replaces No. 2 (2015). Rayburn WF, Klagholz JC, Elwell EC, Strunk AL. Maternal-Fetal Medicine Workforce in the United States. Am J Perinatol. 2012;29(9):741-746, based on the 2010 ACOG roster.
Related: About Ouma · Levels of maternal care · Maternal-fetal medicine explained
