PC1269: Teleicn: Using Telehealth to Support Community Providers in the Care of Sick Newborns

Background: Use of telehealth has rapidly expanded across medicine. However, use in neonatology has been limited. The Intensive Care Nursery (ICN) at Dartmouth-Hitchcock is a level III NICU in a tertiary care center in rural Northern New England. We hypothesized that there was a demand and use for telehealth to support community pediatricians and associate providers with care of newborns in our rural region. Our objective here is to describe our experience using our TeleICN program.

Methods: From January 2021 to March 2022, TeleICN was set-up in eight referral hospitals in the region using Vidyo® app (Hackensack, New Jersey) on a tablet or mobile video cart. This allowed local community providers to use a secure video connection to consult with the one of the neonatologists from the ICN as needed. Demographic and clinical data were collected on all consults, including birth weights, gestational ages, Apgar scores, and the reasons for the call. Electronic surveys were also sent to local providers following the calls to evaluate the ease of use of telehealth and its impact on the care.

Results: During this timeframe, TeleICN received 55 calls from local pediatricians or providers. Full data was available on 48. The mean birth weight was 3.08kg (range 1.25-4.61kg), the mean gestational age 37 5/7 weeks (range 29 2/7-41 3/7 weeks). The median Apgar scores were 6 and 7 at 1 and 5 minutes, respectively. The majority of calls (n=32) were for respiratory concerns or respiratory distress. Followed by evaluation of hypoxic-ischemic encephalopathy or neurologic concerns (n=11). 33 of the 55 infants (60%) required transfer to higher level of care. Follow up surveys were completed by 20 local pediatricians or providers. All respondents (n=20) felt the technology to be easy to use. 85% of respondents felt the use of telehealth improved the care of the newborns.

Conclusion: Using telehealth for neonatologists to support local pediatricians in a rural setting is feasible and useful. It is a service that can provide valuable information above simple phone consultations and can improve the care of sick newborns. This is of particular value in settings, like ours, where travel may be long or difficult.