Access to Fetal Cardiology Care in Diagnosing CHD a Priority for a Pediatric Cardiologist

Joyce L. Woo, MD, MS, is a pediatric cardiologist with advanced training in fetal cardiology, health economics, and health services research. Her clinical focus is advanced cardiac imaging and the prenatal diagnosis and management of congenital heart disease (CHD). Her research broadly relates to improving the efficiency of care delivery for CHD patients through the study of topics such as regionalization, reimbursement structures, access to and equity of care. 

Her current work focuses on the mechanisms by which patients access prenatal CHD diagnosis, how prenatal diagnosis impacts access to a congenital heart center, and its impact on healthcare expenditures. Prenatal diagnosis of CHD requires the use of fetal echocardiography, an imaging technology with up to 90% sensitivity. However, national prenatal diagnosis rates remain only 30-50%. Further, clear disparities exist in prenatal CHD diagnosis. For example, publicly insured patients have prenatal diagnosis rates up to three times lower than the privately insured. Dr. Woo aims to understand the causal pathways that lead to these types of disparities, and what can be done to mitigate them. In the long run, she hopes this work will contribute to policy that will allow every child with CHD to start on equitable footing, beginning in the fetal period.