Amber N. Watters, MD, Drives Quest for Better Obstetrics Care

Fetal heart tracings (FHTs) are an essential tool for obstetricians, as they allow clinicians to evaluate a baby’s health throughout labor and intervene if needed. But accessing them and documenting them has not always been as easy as care teams would hope. Now, that’s changed, thanks to Obstetrician and Gynecologist Amber N. Watters, MD, medical director of Labor and Delivery at Northwestern Medicine Prentice Women’s Hospital, and other team members at Northwestern Medicine.

Dr. Watters and collaborators helped develop a new app called LaborLink to address FHT access issues. It allows convenient access to the data via mobile device, such as when seeing patients in the office while on call, when rounding or doing circumcisions, and when resting in a call room during latent labor.

LaborLink is one of several physician-led collaborations at Northwestern Medicine that are improving patient care, physician workflow and clinician well-being.

Opportunity for Faster Response

Before LaborLink, accessing FHT data required logging in to a computer, a process that could be slow and didn’t facilitate easy documentation, says Dr. Watters, who played a lead role in developing the app. In the past, to respond to a page for FHT review, the obstetrician would have to step away from their current task, get to a computer and click through six screens to look at the data.

Any wait could be stressful, explains Dr. Watters, “especially in the context of a 10- to 24-hour shift where you’re managing a number of patients in labor and switching among multiple tasks.”

A Collaborative Solution

Beginning in September 2021, Dr. Watters and a working group of physicians representing 13 of the 18 obstetrics practices at Prentice Women’s Hospital came together with the Information Services (IS) Department to create a solution.

On the IS side, the project was led by Mozziyar Etemadi, MD, PhD, clinical director of Advanced Technologies, and his team. Stacey Caron, RN, oversaw much of the coordination, and Data Scientist David Melnick was lead engineer. Patrick Creamer, an IS program manager, then scaled LaborLink up for wider use across Northwestern Medicine.

The first iteration of LaborLink was designed based on the physicians’ assessment of their needs, says Melnick. The physicians tested each subsequent iteration with real-world use and provided feedback, allowing the IS team to make adjustments to ensure the app functioned smoothly.

LaborLink loads on physicians’ phones in less than five seconds. It provides only the data the physicians requested, and it interfaces with Epic — the electronic medical record system that our organization uses — for easy documentation.

Better Physician Workflow — and Well-Being

Care teams at Prentice have been using LaborLink since January 2023. The app is expected to next go live at Northwestern Medicine Central DuPage Hospital, and care leaders are currently determining the best method and time frame for bringing the app to more locations across the organization.

Future iterations will incorporate worklists ordered by acuity and predictive artificial intelligence (AI), Caron says. For example, AI could predict the next 10 to 30 minutes of FHTs and alert obstetricians when they might be needed at bedside.

“Obstetrics is a stressful and litigious field, and obstetricians have a very high burnout rate,” Dr. Watters says. “LaborLink reduces stress because it lets us respond a few minutes earlier to a potential need, and it makes it easier to document that we took action.”