Deploying an agentic AI nurse to boost maternal care outcomes

HOW DOES THE PROGRAM WORK?

The linchpin of the Healthy Baby pilot program is Drive Health's Nurse Avery. According to Kevin Longoria, CEO of the AI-driven health technology company, Nurse Avery is designed to provide 24/7 access to maternal healthcare.

Unfortunately, the healthcare system does not have the ability to call expecting mothers on a weekly basis just to ask how they're feeling, to monitor their progress, to help them coordinate their preventive visits, and so on. So, [Nurse Avery is] really an approach of proactive engagement for expectant mothers in a very medically underserved population.

The agentic AI nurse offers nutritional support, including guidance to ensure sufficient folic acid intake, vaccination updates and coordination and information to help patients manage chronic diseases. The solution also provides mental health resources and access to lab-based genetic screenings.

"Unfortunately, the healthcare system does not have the ability to call expecting mothers on a weekly basis just to ask how they're feeling, to monitor their progress, to help them coordinate their preventive visits, and so on," Longoria said. "So, [Nurse Avery is] really an approach of proactive engagement for expectant mothers in a very medically underserved population."

The solution is trained on both the patient's health information and their doctor's prescribed care plan, enabling personalized and culturally sensitive care. For instance, Nurse Avery will not suggest an all-organic Whole Foods diet if the patient lives in a community where the gas station is the only source of groceries, Longoria noted.

Participants in the Healthy Baby pilot will receive a health kit, which includes a Google Pixel phone to connect with Nurse Avery and a Fitbit wearable device to track various metrics, like physical activity, heart health and sleep data. The devices come with unlimited 5G connectivity.

Data from the wearable tracker enables clinicians to intervene early if a patient requires more support. Clinicians can monitor the data via a dashboard and adjust care plans, using Nurse Avery as needed.

"If somebody has a rapid change in their sleep, not necessarily less than six to eight hours, but some acute change from their specific baseline, [Nurse Avery] simply contacts the patient and says, 'How are you feeling? We're noticing a small change in your physical activity or your sleep or your heart rate,'" Longoria explained.

Several federally qualified health centers in Cook County have been enrolled in the program, and clinicians from these centers can essentially 'prescribe' the program to their pregnant patients, he added.

The phone and smartwatch are provided to program participants free of charge, primarily to mitigate the digital divide. 

"We didn't want to make an assumption that folks would have their own smart devices and smart watches and all those kinds of things," said Chris Hein, field chief technology officer at Google Public Sector. "We wanted to remove that barrier."

Hein added that Google Cloud houses the analytics portfolio and the backend for the application processing in a HIPAA-compliant environment.

WHAT IS THE WHY?

Like many areas of the country, Cook County desperately needs maternal healthcare innovation.

One significant challenge plaguing the county is a trenchant network adequacy issue, which means that there are not enough maternal care providers to meet the growing demand, Longoria said. This has resulted in a disproportionate number of preterm births, low birth weight infants and rising neonatal intensive care unit (NICU) utilization. The agentic AI solution democratizes access to important prenatal and pregnancy information that people may otherwise not receive due to the lack of maternity care providers.

We didn't want to make an assumption that folks would have their own smart devices and smart watches and all those kinds of things. We wanted to remove that barrier.

Further, the higher the healthcare utilization due to poor maternal outcomes, the more expensive maternal healthcare is for state health plans. Former Illinois State Senator James F. Clayborne Jr., who is involved in the Healthy Baby pilot program, noted that one of the pilot's goals is to "create a more transformational payment model so that we can increase or improve the current network of physicians and specialists that take Medicaid."

The pilot could serve as evidence that strategic and proactive engagement of pregnant people can improve maternal health outcomes and save managed care organizations money, he continued.

For instance, the solution will leverage analytics to incentivize and encourage patients to make the lifestyle modifications needed for a healthy pregnancy, such as improving their nutrition or taking their medications on time.

"[We want to] show that these high-risk pregnancies or these outliers based upon different diseases can be improved with real engagement, which is where Avery comes in," Claybourne said.

Additionally, the conversational nature of the agentic AI nurse is expected to drive engagement.

"It can do everything via voice…When [patients] have questions and when they want to know more, the great thing about the different AI services that are available through Nurse Avery is that it can be conversational," Hein pointed out.

Not only does the ability to converse with the AI encourage proactive engagement, but it also helps reduce barriers to technology use, as people are not expected to download an app or configure a new device, he added.

WHAT'S NEXT?

The pilot's leaders aim to roll out the program to 100 participants in July and plan to grow that number to about 5,600 by the end of the year.

Everyone should be entitled to have access to equitable care that hopefully promotes healthy babies, healthy mothers and safe births.

The primary goal, of course, is to enhance maternal health outcomes in Illinois. Hein stated that program leaders will assess the impact using various metrics, including outcomes like infant birth weights and NICU utilization, as well as patient adoption and experience.

"Where we're really excited is that because you're going to get this wealth of information coming off of both devices and then the user feedback of the women going through the program, that really gives us this much broader set of data that we're going to be able to work off of to be able to say, what were the outcomes? What was the user experience? Are there things that we can make simpler for them?" he said.

In addition, program leaders aim for the pilot to serve as a blueprint for similar programs in other parts of the state and country. Longoria noted that Cook County residents face numerous SDOH challenges that could make having a healthy pregnancy harder, such as large food deserts. So, he reasoned that if the pilot can achieve improved outcomes here, it should also be possible in other parts of the state and beyond.

Ultimately, the United States must close the maternal health gap to match maternal health outcomes in other high-income countries. The overarching target is to ensure good maternal health outcomes regardless of financial status, zip code or other SDOH, Claybourne underscored.

"Everyone should be entitled to have access to equitable care that hopefully promotes healthy babies, healthy mothers and safe births," he said.

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.