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Tytuł:
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The Use of Telemedicine for Stabilization of Neonates Transferred from Rural Community Hospitals.
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Autorzy:
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Haynes SC; Department of Pediatrics, University of California Davis, Sacramento, California, USA.
Hoffman KR; Department of Pediatrics, University of California Davis, Sacramento, California, USA.
Patel S; Department of Pediatrics, St. Francis Health System, Tulsa, Oklahoma, USA.
Smith S; Department of Pediatrics, University of California Davis, Sacramento, California, USA.
Romano PS; Division of General Medicine, Center for Healthcare Policy and Research, University of California Davis, Sacramento, California, USA.
Marcin JP; Department of Pediatrics, University of California Davis, Sacramento, California, USA.
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Źródło:
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Telemedicine journal and e-health : the official journal of the American Telemedicine Association [Telemed J E Health] 2021 Dec; Vol. 27 (12), pp. 1393-1398. Date of Electronic Publication: 2021 Mar 01.
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Typ publikacji:
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Journal Article; Research Support, U.S. Gov't, P.H.S.
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Język:
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English
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Imprint Name(s):
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Original Publication: Larchmont, NY : Mary Ann Liebert, Inc., c2000-
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MeSH Terms:
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Hospitals, Rural*
Telemedicine*
Child, Preschool ; Hospitals, Community ; Humans ; Infant, Newborn ; Referral and Consultation ; Telephone
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Contributed Indexing:
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Keywords: neonatology; stabilization; telemedicine; transfer
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Entry Date(s):
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Date Created: 20210310 Date Completed: 20211221 Latest Revision: 20211221
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Update Code:
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20240105
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DOI:
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10.1089/tmj.2020.0503
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PMID:
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33691080
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Background: For newborns requiring transfer to a higher level of care, stabilization before the arrival of the transport team is essential. Telemedicine consultations with a neonatologist may improve local providers' ability to stabilize a newborn during this critical interval. The purpose of this study was to describe the use of telemedicine for stabilizing newborns who were transferred from one of six rural hospitals to a regional neonatal intensive care unit in northern California and to examine the association between telemedicine use and time needed to stabilize the newborn. Materials and Methods: We collected data on all newborns who were transferred after either a telemedicine or telephone consultation with a neonatologist between April 2014 and June 2018. We used multiple regression to examine the association between the use of telemedicine and stabilization time, adjusting for gestational age, 5-min Apgar score, birth weight, site, and primary reason for consultation. Results: In total, 162 infants (77.5%) received a telephone consultation and 47 (22.5%) received a telemedicine consultation. Neonates who received telemedicine had a significantly greater severity of illness, as measured by mean 5-min Apgar score (6.9 vs. 7.8, p = 0.008) and Transport Risk Index of Physiologic Stability version II (TRIPS-II) score (14.4 vs. 6.0, p < 0.001). There was no significant difference in stabilization time for telemedicine consultations compared with telephone consultations in the adjusted analysis (adjusted mean difference: -1.80, 95% confidence interval: -16.0 to 12.4, p = 0.802). Conclusions: Although we found no difference in stabilization times between modes of consultation, telemedicine may be helpful for stabilizing infants with a higher severity of illness, particularly those in respiratory distress. Future studies should examine the impact of telemedicine on specific interventions.