Neonatal Abstinence Syndrome (NAS)

Problem: Newborns born to mothers with maternal opioid abuse suffer drug withdrawal symptoms.  This condition, called Neonatal Abstinence Syndrome (NAS), impacts 6 in 1000 babies born in the US. This is a growing issue (300% growth according to CDC) and an unintended consequence of the opioid crisis.  NAS could also occur when the baby is exposed to medications such as barbiturates and antidepressants in the womb.  The challenges in ensuring appropriate, standardized care across the continuum is immense, and the cost burden to society and Government is significant, $17 Billion in direct and indirect healthcare costs and child & family asistance.  $1.2 Billion, or 80% of the $1.5 Billion in initial hospital costs to take care of these babies has been paid for by Medicaid.

NAS Fast Facts

These babies are in pain, jittery, have gastrointestinal issues, poor weight gain, poor feeding and have 2.5 times higher readmission rates in the first month after discharge. Typically, clinical protocol pathways for NAS include drug screen for risk assessment and scoring of the symptoms using the Finnegan method that provides insights on the drug dosage (mostly morphine) for the weaning process. This scoring method is highly subjective and can lead to outliers and lengthening of the weaning process. The clinical pathway (printout) is followed manually. This is tedious, complex and can lead to errors. The overall treatment also involves a prenatal and postnatal consult with brochures/guides for care after discharge.

NAS newborn care is currently across multiple hospital/non-hospital care sites with follow-up checkups through pediatrician or a NAS clinic. Social determinants of health play a key factor, with around a third of the infants needing social services/child welfare support. The mothers typically have behavioral/mental health issues with high incidence of postpartum depression and likelihood for overdose. Long-term effects of this condition are still not completely known though developmental delays, visual acuity, respiratory issues are known to occur requiring potential chronic treatment.  Customer discovery shows that the current reimbursement model is not focused on “value based” care for NAS. Providers are losing money on NAS treatments and cost control approaches have resulted in lower hospitalization costs but increased length of treatment for the patient overall (GAO report to Congress on Newborn Health, 2017).  Current care delivery/planning efforts are largely manual and more focused on short-term clinical impact.

swaddletool-logoSolution:  Swaddle is a complete Cloud-based digital health solution for patient centered care management for NAS baby & mother across the continuum. It is designed to reduce potential harm for the infant and ensure Triple Aim of  improved quality, reduced costs across the board and superior care across transitions with social services interventions for enhanced patient experience.  It will facilitate appropriate use, virtual psychological support through augmented reality (AR) and telemedicince tools and personalized interventions to drive safe & effective recovery.  Patient engagement through virtual prenatal and postnatal consult/checks and analytics will enable quality focused treatment across the NAS population. A mother-baby approach for recovery will ensure higher success rates for a stable home, stable health, and stable future!


Contact us for further information and demonstration.