Researchers at the University of Pennsylvania asked patients with high-risk pregnancies, who did their nonstress tests at home with INVU, what the experience was like, through weekly surveys and in-depth interviews. Patients rated home monitoring acceptable and said it spared them travel, childcare and missed work. Belt fit and comfort were what they most wanted improved, and those comments led to changes in the device.
What it is
A research letter in the American Journal of Obstetrics & Gynecology MFM (2024) by a University of Pennsylvania team. It is the patient side of two Penn cohorts that used INVU for clinically indicated nonstress tests from home between October 2020 and March 2023. The clinical results of the first cohort are in an earlier Penn paper.
Why it was studied
Pregnancies at high risk need frequent nonstress tests, and getting to the clinic is limited by transport, childcare and work. Penn had already shown that most home tests with INVU were clinically acceptable and replaced the clinic visit. What patients thought of it had not yet been measured, and the authors note that no new form of care spreads without it.
How it was done
Mixed methods. Every patient in the two cohorts who had tried at least one home test received a weekly survey: a validated four-question acceptability measure (scored from 4 to 20) and open questions about the experience. From May 2022, 12 patients also took part in long interviews, until no new themes came up.
The interviews were run by a researcher outside the cohort studies and coded by two qualitative researchers who were not involved either; a fifth of the transcripts were coded twice, with near-complete agreement.
What they found
Acceptable. 40 of the 56 patients (71.4%) answered 105 surveys. The median score was 15 of 20.
The benefit. Avoiding clinic visits was named in 59.6% of answers, ease and speed of the device in 14.6%; a few named traffic and parking, or cost.
The problems. Belt connection (18.1% of surveys) and belt fit or comfort (15.2%).
What to change. 46.1% of answers said nothing; 37.1% asked for a better belt fit or comfort.
At home. Patients tested in bed or a reclining chair, usually in under an hour, working or watching TV. Most felt reassured that the monitoring matched the clinic, and valued talking with clinicians through the app. Some wanted more help with set-up; one found keeping still hard; one raised fit for different body types; others noted that small children at home still take planning.
“…and also to share that experience with my husband.”
A patient, on seeing the baby’s heart rate at home (Table 2 of the paper).
Why it matters
The feedback went straight into the product: the paper reports that INVU was updated to improve comfort and signal reliability, and that the app’s troubleshooting was extended for different body types. This happened before Penn began a randomised trial comparing home and clinic testing. Read with the Penn clinical results and the Banner Health experience.
What it does not show
It measured acceptability inside a research cohort, not in routine care, and the authors expect some barriers to differ outside it. Comparisons with clinic visits may reflect unit or COVID-19 rules of the time. The 12 interviewees were not typical of the whole group (for example, more had private insurance). The device and training changed between the two cohorts. It did not compare home and clinic testing head to head, or look at outcomes.
Who ran it
The University of Pennsylvania (Obstetrics & Gynecology, the Leonard Davis Institute and the Mixed Methods Research Lab). Funded by Penn’s Institute for Translational Medicine and Therapeutics, Nuvo Group and the National Institute of Child Health and Human Development. One author, Dr Nadav Schwartz, is a medical advisor and consultant to Nuvo; the paper states he took no part in collecting or analysing the acceptability data. Nuvo could review the report before publication but took no part in writing it.
