Skip Navigation

Strengthen the Evidence for Maternal and Child Health Programs

Sign up for MCHalert eNewsletter

Evidence Tools
MCHbest. Postpartum Mental Health Screening.

MCHbest Logo

Strategy. Telemedicine

Approach. Provide telemedicine to promote reproductive healthcare.

Return to main MCHbest page >>

Overview. Telemedicine uses information-communication technologies to provide clinical services between patients and healthcare providers or to share clinical information between providers. Telemedicine includes video conferencing or telephone-only visits, provided synchronously in real time, with patient-provider interaction, or asynchronously, where the patient and provider exchanges messages, text, images, or other materials.[1, 2] Telemedicine is sometimes called telehealth, but telehealth can be understood as broader than telemedicine and can refer to other health services and medical education or training provided remotely.[1]

Evidence. Moderate Evidence. Strategies with this rating are likely to work. These strategies have been tested more than once and results trend positive overall; however, further research is needed to confirm effects, especially with multiple population groups. These strategies also trend positive in combination with other strategies. (Clarifying Note: The WWFH database calls this "some evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. What Works for Health (WWFH) Database (County Health Rankings and Roadmaps)

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Outreach (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Individual/Family-Focused

Examples from the Field. There are currently no ESMs that use this strategy. As Title V agencies begin to incorporate this strategy into ESMs, examples will be available here. Until then, you can search for ESMs that have similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of healthcare providers trained by Title V to deliver postpartum mental health screening and care services via telemedicine. (Shows the workforce capacity and readiness for the approach)
  • Number of postpartum women who access and utilize telemedicine services supported by Title V for mental health screening, assessment, and treatment. (Indicates the reach and engagement of the population served)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of telemedicine services led by Title V for postpartum mental health screening and care that adhere to evidence-based guidelines, clinical protocols, and quality standards. (Shows the fidelity and reliability of the approach)
  • Percent of postpartum women who receive appropriate mental health screening, education, and support through telemedicine services. (Indicates the patient-centeredness of the approach)

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of partnerships and care coordination initiatives established between obstetric providers, mental health specialists, and telemedicine platforms to support seamless postpartum mental health screening and care delivery. (Shows the multi-disciplinary collaboration and integration in the approach)
  • Number of innovations implemented to support the sustainable and scalable implementation of telemedicine for postpartum mental healthcare that results in improved outcomes. (Indicates the enabling environment and systems change approach)

OUTCOME MEASURES:

  • Number of healthcare organizations partnered with Title V that demonstrate improved postpartum mental health outcomes, patient satisfaction, and cost savings through the implementation of telemedicine-based screening and treatment services. (Shows the healthcare value and return on investment of the approach)
  • Number of maternal mental health supporters, peer supporters, and provider champions who emerge and lead the movement for expanding access to and quality of telemedicine-based postpartum mental health screening and care. (Indicates the leadership and support outcomes of the approach)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • Percent of innovations implemented to support the sustainable and scalable implementation of telemedicine for postpartum mental healthcare that results in improved outcomes. (Indicates the enabling environment and systems change approach)
  • Percent of telemedicine providers, researchers, and policymakers partnered with Title V involved in postpartum mental healthcare who reflect the intersectional identities of the postpartum women and communities they serve. (Indicates the representativeness of the workforce and leadership driving the approach)

OUTCOME MEASURES:

  • Percent reduction in stigma and structural barriers that prevent postpartum women from seeking and accessing mental health screening and care, as a result of the convenience, privacy, and normalization effects of telemedicine-based services. (Shows the social change outcomes of the approach)
  • Percent of overall maternal and child health indicators, such as rates of healthy mother-child bonding, parenting self-efficacy, and family resilience, that improve at the population level through the increased access to and quality of postpartum mental health screening and care via telemedicine. (Indicates the long-term, intergenerational impact of the approach on health outcomes)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Shaver 2022 - Shaver J. The state of telehealth before and after the COVID-19 pandemic. Primary Care: Clinics in Office Practice. 2022;49(4):517-530.

2 HRSA-HHS Telehealth - Health Resources & Services Administration (HRSA). Telehealth.HHS.gov.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.