Peripartum Telehealth Care Utilization During the COVID-19 Pandemic, by Hypertension Status, PCORnet^®, 2018 to 2023

Objective: – To examine telehealth care utilization during pregnancy and in the 6 months postpartum during the COVID-19 pandemic. Research Design: – We used a repeated cross-sectional design to assess aggregated and standardized electronic health records (EHR) from 28 participating US health systems in the PCORnet^®, National Patient-Centered Clinical Research Network. Subjects: – We studied women aged 18–55 years with delivery records from 2018 to 2019 (prepandemic), 2020–2021 (early pandemic), and 2022–2023 (late/postpandemic). Women with hypertension in pregnancy (HTN-PREG) were identified as those with documented hypertension 1 year prepregnancy or during pregnancy (40 wk predelivery). Measures: – We used the International Classification of Disease Clinical Modification/Procedure Classification codes, a normalized naming system for drug names (RXnorm), and the Current Procedural Terminology/Healthcare Common Procedure Coding System to identify deliveries, hypertension, and telehealth visits. Results: – We examined 1, 028, 426 deliveries, of which 108, 606 had HTN-PREG. The proportion of women with 1+ pregnancy telehealth use was higher in the early pandemic (15.8%) and late/postpandemic (16.4%) periods compared with prepandemic (0.2%). Telehealth use among HTN-PREG women was higher than among all women (0.24% prepandemic, 24.9% early pandemic, 26.8% late/postpandemic).. Among HTN-PREG women, telehealth use was lower among Hispanic women (19.2% and 23.2%) compared with NH Black (26.5% and 29.3%) or NH White (24.5% and 26.1%) women during the early and late/postpandemic periods, respectively. We observed similar patterns postpartum. All P values for comparisons were <0.001. Conclusions: – These findings underscore the value of aggregate PCORnet^® data infrastructure and other standardized electronic health records in analyzing health care utilization trends and racial and ethnic differences among pregnant women.