The costs and potential savings of telemedicine for acute care neonatal consultation: preliminary findings

Armfield, Nigel R; Donovan, Tim; Bensink, Mark; Smith, Anthony C

doi:10.1258/jtt.2012.gth101

Cited by 39 publications

(33 citation statements)

References 3 publications

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“…These positive impacts of telemedicine on avoiding unnecessary transports and cost savings have been consistently found among published reports, including evaluations done internationally. 27,161,162 Intensive Care…”

Section: Telemedicine In the Intensive Care Settingmentioning

confidence: 99%

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Satou¹,

Rheuban²,

Alverson³

et al. 2017

Circulation

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A dvancements in technology and broadband have revolutionized the current practice of medicine. The field of pediatric cardiology is no exception given the need for prompt diagnosis and reliance on cardiac imaging to identify infants and children with potentially life-threatening cardiovascular disease. As the relationship between telemedicine and pediatric cardiology has advanced, it has created a need to develop a broad, comprehensive document reviewing all the various aspects of telemedicine in pediatric cardiology. For more than a decade, a significant body of literature has been published describing individual experiences and practices, yet there remains no comprehensive statement or document summarizing this rapidly advancing field. In an effort to describe the collective experience and to provide structure and guidance for pediatric cardiology practitioners and healthcare providers, we have developed a scientific statement on the use of telemedicine in pediatric cardiology.Specific areas explored in this document include both neonatal and fetal teleechocardiography, implications for training community sonographers, pulse oximetry programs, qualitative improvement and appropriate use criteria initiatives, and remote electrophysiological monitoring. This document also includes teleconsultation and teleausculation, direct-to-consumer and home monitoring programs, and a look into the use of telemedicine and pediatric cardiology in the intensive care setting. Furthermore, a detailed review of the legislative, public policy, and legal aspects of telemedicine is provided, along with financial and reimbursement information.Several terms are used in the literature interchangeably; a brief explanation is provided to help readers of this document. The term telehealth is defined as the use of technology to bridge distances in any aspect of medicine; telemedicine is the specific application of technology to conduct clinical medicine at a distance. The term telecardiology is defined as the broad application of telemedicine in the field of cardiology specifically, and tele-echocardiography is the most common application used within this field. ECHOCARDIOGRAPHY AND TELEMEDICINEEchocardiography is the most commonly used noninvasive cardiovascular imaging modality and is considered to be both safe and cost-effective. Tele-echocardiography can be described as a process in which a provider or a technician obtains cardiovascular ultrasound images from a given patient and these images are subsequently transmitted to an offsite location where a cardiologist can provide further analysis and interpretation. Thus, tele-echocardiography enables expert interpretation and consultation in a rapid and potentially geographically disparate fashion, enabling prompt and accurate decision making involving triage, transport, and therapeutic priorities. Tele-echocardiography is now routinely used across the age and subspecialty spectrum in pediatric cardiology.

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Section: Telemedicine In the Intensive Care Settingmentioning

confidence: 99%

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Satou¹,

Rheuban²,

Alverson³

et al. 2017

Circulation

View full text Add to dashboard Cite

show abstract

“…7 In a second study, 5 of 19 neonates who underwent tele-consultation avoided transport, and as a result use of telemedicine was associated with substantial cost savings. 20 Overall, clinicians report having a positive impression of telemedicine for neonatal consultation. 8 There have been more limited studies of telemedicine use for subspecialty evaluation of neonates, and they have generally focused on image interpretation and not performance of a full subspecialty physical examination.…”

Section: Discussionmentioning

confidence: 99%

“…7, 8, 19, 20 A recent study comparing bedside and telemedicine neonatologist evaluations of 46 neonates found excellent or intermediate-to-good agreements for almost all components of the evaluation. However, poor agreement was identified for several physical examination features including auditory components (breath, cardiac, bowel sounds) and capillary refill time.…”

Section: Discussionmentioning

confidence: 99%

Telemedicine for genetic and neurologic evaluation in the neonatal intensive care unit

et al. 2014

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Objectives Evaluate whether telemedicine can be used to perform dysmorphology and neurologic examinations in the neonatal intensive care unit (NICU) by determining the examination accuracy, limitations, and optimized procedures. Study design Prospective evaluation of NICU patients referred for subspecialty consultation for dysmorphic features (n=10) or encephalopathy (n=10). A physician at bedside (bedside clinician) performed an in-person examination which was viewed in real-time by a remote physician (remote consultant). Standardized examinations were recorded and compared. Subsequently, a qualitative approach established technique adjustments and optimization procedures necessary to improve visualization. Results Telemedicine examinations identified 81 of 87 (93%) dysmorphology examination abnormalities and 37 of 39 (92%) neurologic examination abnormalities. Optimization of remote consultant visualization required an active bedside clinician assisting in camera and patient adjustments. Conclusions Telemedicine can be used to accurately perform many components of the dysmorphology or neurologic examinations in NICU patients, but physicians must be mindful of specific limitations.

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“…Telemedicine applications in the intensive care unit (ICU) have been designed to improve quality of care and access to health care, especially for those who live in remote or underserved areas. The importance of telemedicine in general neonatal care has been reported as improving patient outcomes, communication, accessibility, and reducing cost of care . In a comparison of actual costs of neonatal telemedicine with actual savings associated with confirmed avoided infant aeromedical transport and nursery costs, there were net savings to the health system of 54,400 AUD (Australian Dollars), which were associated with the use of neonatal telemedicine over a period of 12 months .…”

Section: Introductionmentioning

confidence: 99%

“…The importance of telemedicine in general neonatal care has been reported as improving patient outcomes, communication, accessibility, and reducing cost of care . In a comparison of actual costs of neonatal telemedicine with actual savings associated with confirmed avoided infant aeromedical transport and nursery costs, there were net savings to the health system of 54,400 AUD (Australian Dollars), which were associated with the use of neonatal telemedicine over a period of 12 months . Utilization of telemedicine has also proved to reduce the number of low birth weight deliveries in hospitals without NICUs, and reduce statewide infant mortality .…”

Section: Introductionmentioning

confidence: 99%

Health Care Professionals' Perspectives on Teleneonatology Through the Lens of Normalization Process Theory

Asiedu

Fang

Harris

et al. 2019

Health Science Reports

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Background and aims Little research has been done on tele‐intensive care unit (ICU) implementation across different types of ICUs, and there exist few studies that have used qualitative research methods to analyze the human and organizational factors influencing optimization of telemedicine for newborn resuscitation. The objective of this study was to understand health care professionals' acceptance, utilization, and integration of video telemedicine for newborn resuscitation (termed teleneonatology) in community hospital settings. Methods Focus group and individual interviews were conducted with 49 health care professionals at six affiliated health system hospitals. Data were gathered from physicians (n = 18), nurses (n = 30), and a nurse practitioner. Data were inductively analyzed using a thematic approach, and then constructs from normalization process theory (NPT) were deductively applied. NPT rendered a general framework to describe and assess how care teams perceive the implementation of teleneonatology and how they interact with this telemedicine service in their local setting. Results Local health care professionals accepted teleneonatology as an important, helpful service, yet its implementation was perceived as both valuable and a threat to professional traditions. Utilization may depend on perceived benefit, mutual understanding of the guidelines, and expectations of use, and other relational, human, contextual, and system factors. Participants in this study agreed on the need for collective work to successfully integrate teleneonatology into the local practice. Discussions NPT uncovered that successful implementation of a teleneonatology program may be facilitated by strong interpersonal relationships among care teams, continuous programmatic training and education, and communicating the clinical value of teleneonatology, including its opportunities and benefits.

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The costs and potential savings of telemedicine for acute care neonatal consultation: preliminary findings

Cited by 39 publications

References 3 publications

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Telemedicine for genetic and neurologic evaluation in the neonatal intensive care unit

Health Care Professionals' Perspectives on Teleneonatology Through the Lens of Normalization Process Theory

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