April 7, 2021

The Honorable Bob Menendez United States Senator Washington, District of Columbia 20510

The Honorable Dan Sullivan United States Senator Washington, District of Columbia 20510

Dear Senator Menendez and Senator Sullivan,

Thank you for your leadership in introducing legislation to address inequities in access to maternal care through tech-driven digital health tools. We write to express our support for the Tech to Save Moms Act (S. 893), an important standalone piece of the broader Momnibus package in the 116th and 117th Congresses. The bill calls on the U.S. Department of Health and Human Services (HHS) to explore and make investments to ensure that providers and perinatal patients, especially those who are at risk, can leverage digital health tools to improve outcomes and reduce mortality. For example, the bill would add a statutory provision encouraging the Center for Medicare and Medicaid Innovation (CMMI) to test the “adoption of and use of telehealth tools that allow for screening, monitoring, and management of common health complications with respect to an individual receiving medical assistance during such individual’s pregnancy.”1 Similarly, the bill would also establish two grant programs to provide resources for providers to weave digital health and telehealth into their perinatal care programs. This is welcome legislation recognizing that digital health plays a central role in a variety of contexts, including perinatal and maternal care, and will help policymakers better understand how tech-driven tools can be used to address inequities in outcomes and access.

African-American mothers face tragically high maternal mortality rates as compared to other races in the United States. According to the Centers for Disease Control and Prevention (CDC), the mortality rate per 100,000 live births for African-American mothers is 43.5, as compared to 14 per 100,000 live births for all U.S. mothers.2 For policymakers, a critical aspect of addressing this inequitable and unacceptable outcome is to ensure that all mothers can access perinatal care. Remote monitoring tools are especially effective in the perinatal monitoring context. For example, remote monitoring tools can help providers monitor a variety of patients with gestational diabetes and prioritize the cases by severity to optimize their interventions.3 Similarly, providers can leverage wearable devices with sensors to track maternal and fetal heart rates over time to inform the heart

1 Tech to Save Moms Act (S. 893, 117th Cong.), Sec. 3. 2 Gianna Melillo, “Racial Disparities Persist in Maternal Morbidity, Mortality and Infant Health,” AJMC (Jun. 13, 2020), available at https://www.ajmc.com/view/racial-disparities-persist-in-maternal-morbidity-mortality-and- infant-health. 3 See Sensyne Health, GDm-Health: Personalized care for women with diabetes in pregnancy, available at https://www.sensynehealth.com/gdm-health-us. health of both mothers and their babies remotely.4 Crucially, these tools can help patients who live in rural or urban areas where physical access to obstetricians and gynecologists is difficult or impossible, especially on a regular basis during and after pregnancy. Meanwhile, they also help extend the reach of caregivers to at-risk patients and those in hard-to-reach areas by enabling remote monitoring and more efficient coordination and management. With forecasts predicting the physician shortage in the United States could grow to 139,000 by 2033;5 a rapidly aging population burdened with chronic conditions; and rural health providers shuttering, this legislation is timely to ensure that the U.S. healthcare system enables the use of digital health and telehealth modalities to address these realities and their impact on the equity of health access and outcomes.

We are ready to help any way we can to ensure this legislation becomes law. Thank you for your leadership in ensuring patients and providers can leverage smart devices and software to enable access to critical maternal care.

Sincerely,

Executive Director The Connected Health Initiative

Cc: The Honorable , Chairwoman, Senate Committee on Health, Education, Labor and Pensions The Honorable , Ranking Member, Senate Committee on Health, Education, Labor and Pensions

The Connected Health Initiative (CHI), an initiative of ACT | The App Association, is the leading multistakeholder group spanning the connected health ecosystem seeking to effect policy changes that encourage the responsible use of digital health innovations throughout the continuum of care, supporting an environment in which patients and consumers can see improvements in their health. CHI is driven by its Steering Committee, which consists of the American Heart Association, the American Medical Association, Apple, Boston Children’s Hospital, Cambia Health Solutions, Dogtown Media, George Washington University Hospital, Healthcare Information and Management Systems Society (HIMSS), Intel Corporation, Kaia Health, Microsoft, Noom, Inc., Novo Nordisk, The Omega Concern, Otsuka Pharmaceutical, Podimetrics, Rimidi, Roche, United Health Group, the University of California-Davis, the University of Mississippi Medical Center (UMMC) Center for Telehealth, the University of New Orleans, and the University of Virginia Center for Telehealth.

For more information, see www.connectedhi.com.

4 See Muhammad Mhajna MsC, et al, “Wireless, remote solution for home fetal and maternal heart rate monitoring, AMER. J. OF OBSTETRICS & GYNECOLOGY, Vol. 2, No. 2 (May 2020), available at https://www.sciencedirect.com/science/article/pii/S2589933320300318. 5 ASSOCIATION OF AMERICAN MEDICAL COLLEGES, PHYSICIAN SUPPLY AND DEMAND – A 15-YEAR OUTLOOK: KEY FINDINGS (Jun. 26, 2020), available at https://www.aamc.org/media/10886/download.