A Hybrid Form of Telemedicine: A Unique Way to Extend Intensive Care Service to Neonates in Medically Underserved Areas

Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association
Abhishek MakkarEdgardo Szyld

Abstract

More than 90% of neonatal intensive care units (NICUs) in the United States are in urban areas, denying rural residents' easy NICU access. Telemedicine use for patient contact and management, although studied in adults and children, is understudied in neonates. A hybrid telemedicine system, with 24/7 neonatal nurse practitioner coverage and with a neonatologist physically present 3 days per week and telemedicine coverage the remaining days, was recently implemented at Comanche County Memorial Hospital's (CCMH) Level II NICU. To compare outcomes of moderately ill infants between 32-35 weeks gestational age (GA) managed by our hybrid telemedicine program with outcomes of similar neonates receiving standard care in a Level IV NICU at Oklahoma University Medical Center (OUMC). This was a retrospective, noninferiority study comparing outcomes of neonates receiving hybrid telemedicine versus standard care. All 32-35 weeks GA infants admitted between July 2013 and June 2015 were included. OUMC infants came from areas geographically comparable with CCMH. Infants requiring prolonged mechanical ventilation or advanced subspecialty services were excluded. Outcome variables were length of stay, type and duration of respiratory support, len...Continue Reading

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Citations

Nov 6, 2018·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Hadley S Sauers-FordKristin R Hoffman
Mar 6, 2019·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Abhishek MakkarEdgardo Szyld
May 3, 2019·Current Opinion in Pediatrics·Jonathan E KohlerMary E Fallat
Sep 24, 2020·Journal of Perinatology : Official Journal of the California Perinatal Association·Brianna K BreiZeenia Billimoria
Jul 2, 2019·NeoReviews·Amber M HoffmanKelli Lund
May 16, 2019·Current Opinion in Pediatrics·Jonathan E KohlerMary E Fallat
Jan 16, 2021·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Abhishek MakkarUmakumaran Ponniah
Feb 19, 2021·Archives of Disease in Childhood. Fetal and Neonatal Edition·Juan ArnaezUNKNOWN IC-HIE Study Group
Jan 26, 2021·Current Opinion in Pediatrics·Wannasiri LapcharoensapTrang Huynh
May 5, 2021·Seminars in Perinatology·Abhishek MakkarAbeer Azzuqa
May 11, 2021·Frontiers in Pediatrics·Lory J MaddoxStephen Minton
May 20, 2021·Seminars in Perinatology·Jawahar Jagarapu, Rashmin C Savani
Jun 29, 2021·Seminars in Perinatology·Jawahar Jagarapu, Rashmin C Savani
Jul 11, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Emily M HaydenUNKNOWN Society for Academic Emergency Medicine 2020 Consensus Conference

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