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August 24, 2017

How Mayo Clinic's neonatology telehealth program avoids transfers and saves lives

Daily Briefing

Mayo Clinic four years ago launched a tele-neonatology program to increase regional access to high-acuity neonatology care, successfully providing expertise to community hospitals that otherwise lack such specialization and curbing the need for patient transfers, Bill Siwicki writes for Healthcare IT News.

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According to Jennifer Fang, a pediatrician involved in the tele-neonatology program, "about 10 percent of babies will need some assistance to begin breathing after delivery, and 1 in 1,000 will need extensive resuscitation." She added that research shows "newborns who require advanced resuscitation, especially very premature infants, have poorer outcomes when delivered when delivered at hospitals with lower levels of neonatal care." 

To improve access to specialty care providers, neonatologists from Mayo via the tele-neonatology program can virtually assist physicians at participating community hospitals—which Fang said may only encounter a high-risk newborn resuscitation event "a few times each year"—with high-acuity newborn resuscitation, providing guidance for critical steps such as airway management and effective ventilation. Such access ensures infants can receive specialized care—and helps hospitals curb otherwise necessary transfers, Siwicki writes. 

Positive results

According to Fang, the program has dramatically expanded access to high-acuity neonatology care in the Mayo Midwest region. She said prior to the program, "less than half of newborns [in the region] had access to a neonatologist," but "as of October 2016, ... 100 percent of babies born in the Mayo Midwest region have access to neonatal expertise should they need it."

Since the program launched in 2013, Fang said "we have provided more than 200 tele-neonatology consults." Further, she said, "After a telemedicine consult, approximately one-third of the babies are able to remain in the community hospital—thus avoiding unnecessary patient transfers and keeping babies safely with their families."

The program has also improved quality of care for high-risk newborn resuscitations occurring in community hospitals, Fang said, citing a recent study. "When experts rated the quality of resuscitation on a scale of 1 (poor) to 10 (excellent), the average rating for babies who received a tele-neonatology consult was 7 compared to 4 for similar babies who did not receive a consult." Overall, according to the study, 55 percent of newborns whose care was coordinated via the program received a quality rating of five or higher—compared with 30 percent of newborns who did not receive a tele-neonatology consult.

Fang added that physician feedback on the program has also been positive. According to a Mayo Clinic study, 96 percent of providers said the program boosted patient safety and/or quality of care, and 98 percent of providers said they would use the program again and recommend it to their colleagues (Siwicki, Healthcare IT News, 8/21).

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