Acceptability of Virtual Prenatal Visits for Women with Gestational Diabetes.
Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. Current approaches to GDM management and education are labor intensive and costly. Telemedicine offers a potential solution to reduce the time and cost burden of prenatal care for women with GDM.



We assessed the acceptability of a telemedicine intervention to transmit patients' weight, blood pressure, and blood glucose measurements from wireless devices to health care providers, and to alternate "virtual office visits" with office-based prenatal visits. We administered surveys to 70 Kaiser Permanente Southern California members with GDM to assess preferences for modalities of GDM care delivery and to understand perceptions of telemedicine. We subsequently conducted 10 qualitative interviews among women with GDM to elicit perceptions about confidence and comfort with receiving care telephonically and safety concerns. Data were coded and categorized using analytic induction.



Training on these devices would increase participants' confidence in using the equipment. Continuity of care was perceived as an important factor in facilitating confidence with near universal preference for having virtual visits with the same clinician. Most participants were not concerned with the safety of their baby or themselves during the weeks without an office visit. One participant expressed an unwillingness to participate in the intervention because of a perceived association between having a high-risk pregnancy and an increased risk of pregnancy loss.



As telemedicine becomes increasingly common in health care, feedback from end users will be essential in tailoring, communicating about, and supporting the uptake and success of such programs.
Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California.
Teresa N
TN
Harrison
Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California.
David A
DA
Sacks
Patient-Centered Outcomes Research Center, Improving Healthcare Systems Program, Washington, DC.
Carly
C
Parry
Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California.
Mayra
M
Macias
Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California.
Deborah S
DS
Ling Grant
Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California. Electronic address: Jean.M.Lawrence@kp.org.
Jean M
JM
Lawrence
D000328:Adult; D002140:California; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D009819:Office Visits; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D037841:Pregnant People / Q000523:psychology*; D011295:Prenatal Care; D036301:Qualitative Research; D017216:Telemedicine