Boston's South Shore Health System was facing some challenges with five affiliated OB/GYN physician groups across 40 referring physicians: patient confusion, missed revenue, and negatively impacted Hospital Consumer Assessment of Healthcare Providers and Systems scores.

To overcome these challenges, South Shore built a smartphone app. Using so-called "app-as-a-service" technology and specialized blueprints, the hospital developed a mobile tool that enables it to offer more targeted, consistent messaging and care to all obstetrical patients regardless of practice.

Instead of frustrating patients with irrelevant notifications or pages of unnecessary content, expectant mothers can use the app to connect to everything they need to know at each stage throughout their pregnancy.

South Shore has a lot to crow about when it comes to adding mobility to its OB/GYN operations. Its OB-maternity HCAHPS scores increased by 68 percent, boosting South Shore Hospital from the 53rd percentile to the 89th, and South Shore said the app contributed greatly here.

And with a boost from the app, the hospital's care transitions HCAHPS ranking improved by 40 percent, from the 43rd percentile to the 60th. With more and more hospitals recognizing patient experience as a key way to gain competitive edge, improvements like that are welcome in more ways than one.

Almost 50 percent of new moms have opted for the app over printed handouts. Beyond new referrals, South Shore saved nearly $15,000 in printing costs alone last year, reducing wasted paper-based booklets still used by many OB/GYN practices. Add those cost savings to the long list of benefits digital mobile health apps can help hospitals realize: experience scores, patient education, communication efficiency, and more.

"Our OB/GYN department consists of five different private practices that all deliver babies solely at South Shore Health System," Luke Poppish, executive director of OB-GYN services at South Shore Hospital, explained.

"What that essentially gave us was five different subcultures all merging into our hospital when moms went into labor," he said. "Those subcultures all approached prenatal messaging in different ways and communicated expectations around labor and birth based on their providers."

Breastfeeding, birth plans, expectations for labor experience and details around postpartum care all varied depending on at which practice the mom received her prenatal care. This made it a challenge for South Shore Health System to universally communicate standard processes and approaches once new mothers arrived at a birthing unit and a postpartum unit.

"Obviously, basic and standard prenatal care was provided in a clinically safe and effective manner regardless of practice, but we received a multitude of feedback from a variety of patients who said certain South Shore Health System-specific things were not explained at their OB/GYN office," Poppish said.

DIY app development  

To create the app in-house, South Shore chose the app-building tools of MobileSmith, a digital health app technology vendor. Other app-building vendors include Appery.io, Mendix, Progress Software, ShoutEm and Wellframe.

"MobileSmith is primarily designed to push information, which works very well for us," Poppish said. "Patients can simply download the app and enter their due date only. All of the information is standard and the same regardless of where they receive their care. The app-building platform also offers flexibility and allows us to modify content on the fly rather than having to go back through their development team and our IT team for every minor change."

South Shore used MobileSmith's "Blueprint" program to initiate development – staff there had quickly realized after completing the contracting that the hospital was not going to be able to develop a pregnancy app from scratch to quickly get to market.

Therefore, it agreed to use some standard layouts that MobileSmith already had developed and simply transitioned the generic branding to South Shore Health System colors and branding along with its custom information.

"In turn, we sent MobileSmith quarterly metrics to track the effectiveness of the app in achieving our set goals," Poppish explained. "We sent them PDFs and JPGs of content, and they put it into their framework. We were able to go to market in a matter of weeks rather than months once we had the content shaped and the layouts finalized."

South Shore now is able to tweak various information, add and remove providers, incorporate new content, and update schedules without any assistance from the vendor, which continues to support South Shore when revisions have to get released to the app stores or if South Shore has questions it cannot answer on its own.

"The relationship continues to be very symbiotic as we both benefit from each other's areas of expertise," Poppish said. "We have now launched a bariatric app on their platform and have plans to expand our Neonatal Intensive Care Unit into its own app along with Maternal Fetal Medicine. We are also looking at their Urgent Care/Emergency Department solution."

The pregnancy app has delivered results that South Shore is quite happy with. HCAHPS scores are up and costs are down.

When South Shore first began developing the app, it focused heavily on its "Likelihood to Recommend" HCAHPS score.

"We had middling scores and really wanted to get those to where we thought they should be based on the quality of the care we provided and the moms who had great experiences with us," Poppish recalled. "We saw one of the major gaps being patient-specific communication and expectation management."

South Shore marketed the app, promoted it at the hospital and private practices, and offered a way for expecting moms to contact South Shore directly to ask questions, find information, clarify policies such as rooming-in, or schedule visits and tours.

While the app wasn't the only thing responsible for the increase in HCAHPS scores, Poppish said the unified focus on consistent and clear information definitely contributed.

"We continue to exceed our goals in the HCAHPS realm and attribute some of that success to the app," he said.

South Shore used to spend about $35,000 a year printing maternity booklets alone, not including all of the other brochures and information sheets. South Shore can print five- by seven-inch cards promoting the app for almost nothing, relatively speaking, Poppish said.

"At our offices we now offer the app card first and only give out booklets if requested rather than giving a booklet to every expectant mom," he said. "We have seen our printing costs cut in half based on this effort and save a lot of trees in the process. Our long-term goal is to give app cards 95 percent of the time, which would get our printing costs from $35,000 a year to around $2,000."

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com