The OB-Gyn EHR Gap No One Talks About, And Why It's Time to Rebuild It from the Ground Up

A few months ago, our team had a long call with an OB-Gyn from Ohio. She was juggling high-risk prenatal patients, managing postpartum follow-ups, and navigating new state-level restrictions around reproductive health. And somewhere between that, she was fighting her EHR to simply document a routine visit.

“Our EHR works fine, until I have to step outside the ‘standard flow.’ And OB-Gyn is never standard.”

That conversation stayed with us. Because we’ve heard the same story from New Jersey to New Mexico.

In our 20+ years of building healthcare systems and driving product innovation, we’ve learned this: you can’t retrofit generalist EHRs to meet the needs of specialists, especially OB-Gyns. What’s needed isn’t an upgrade. It’s a specialty-first rethink.

And that begins with compliance, AI, and clinical workflow, because in OB-Gyn, the cost of getting it wrong isn’t just operational. It’s personal.

Why Compliance is the Foundation of OB-Gyn EHR Design, Not a Layer

HIPAA + Reproductive Privacy in the Post-Roe Era

Let’s be real: The post-Dobbs landscape has turned compliance into a legal minefield for OB-Gyn practices. In 2023 alone, 19 states introduced new regulations impacting reproductive care, many with strict enforcement timelines and heightened patient data scrutiny.

Clinics must now ensure:

• Granular role-based access controls (for adolescent privacy and proxy exclusions)
• Audit trails to track every touchpoint with a patient record
• Patient-level permission settings for sensitive visits like abortion counseling,fertility, and STI treatment

Data point: A KFF Health Tracking Poll (2023) showed that 45% of OB-Gyns are concerned that their EHR does not support nuanced privacy controls related to reproductive services. That’s not a small issue, that’s a systemic gap.

Clinical Guidelines: OBRA, ACOG, and Prenatal Protocols

Your EHR shouldn’t require you to remember protocols, it should prompt them.

Yet, many EHRs still lack:

• Prenatal visit flowsheets aligned with ACOG recommendations (e.g., Rh factor testing at 28 weeks, Group B Strep at 36)
• OBRA-mandated screening templates (iron deficiency, gestational diabetes, HIV)
• Smart alerts when screenings or follow-ups fall outside recommended timelines

The risk isn’t just clinical, it’s reimbursement-based too. 88% of payers now tie reimbursement to compliance-based quality measures, including maternal care outcomes (source: CMS, 2024 QPP Performance Guide).

Why AI Isn’t a Buzzword in OB-Gyn, It’s a Clinical Necessity

Let’s cut through the AI noise. Most platforms pitch “AI” as a vague benefit. But when built for OB-Gyn, AI becomes practical and powerful.

Here’s how we’re seeing it reshape real workflows:

McKinsey 2024 Report: AI-supported clinical documentation can reduce OB-Gyn physician admin time by 33%, leading to both burnout reduction and improved coding accuracy.

Revenue Integrity: The Maternity Bundle Isn’t a Billing Shortcut

Too many systems treat OB-Gyn billing like it’s straightforward. It isn’t.

From global maternity bundles (59400) to surgical assists and fertility injections, your billing engine must be:

• Pre-configured to manage global period logic
• Integrated with clearinghouses and ERA/EFT posting
• Smart enough to flag underbilled procedures (which in OB-Gyn can reach 18–22% of claims, per MGMA)

Statistic worth noting: Practices that automate electronic payments and ERA workflows receive reimbursements 12–17 days faster, improving cash flow during critical months like delivery periods (source: HFMA, 2023).

Telehealth & Remote Support: Postpartum Care Is Going Virtual

In 2024, 72% of OB-Gyn clinics are offering at least one form of virtual care, particularly for postpartum follow-ups, fertility counseling, and contraceptive education (American College of Obstetricians and Gynecologists survey).

A modern EHR must support:

• HIPAA-compliant, embedded video visits
• Direct charting during the call (not in a separate window or module)
• Billing codes for telehealth (G2012, 99442, etc.)
• Remote patient monitoring (e.g., blood pressure tracking for preeclampsia risk)

Let’s be clear: Telehealth is not a convenience add-on. It’s core to access and equity in women’s health.

Final Thought: What I’ve Learned from Listening

Across thousands of conversations with OB-Gyn providers, here’s what’s consistent: they want less friction, more focus, and systems that understand the emotional complexity of their work.

Your OB-Gyn platform should:

• Keep you compliant without overwhelming
• Integrate AI where it improves, not complicates, your day
• Make global billing and coding smarter
• Support your patients across clinics, hospitals, homes, and screens
• Give you visibility into how your practice is doing, and where to improve

We didn’t build generic solutions for this specialty. Because OB-Gyn care isn't generic. It’s deeply human.