Researchers at the Mayo Clinic have shown that telemedicine can save the lives of critically ill babies born at hospitals in rural, small, and low-income, urban communities.
The guidance provided by Mayo neonatologists to the neonatal teams at six participating hospitals prevented having to transfer some infants for critical care and helped stabilize others before transfer. Every transfer avoided saved the system $35,000, for a total of more than $1 million over the course of the three-year study, according to lead author Dr. Jennifer Fang, a fellow in neonatal and perinatal medicine at Mayo in Rochester, Minn.
Providers at these hospitals are often ill-equipped to handle newborn emergencies, and often provide a nonuniform level of care that deviates from established guidelines, Fang said.
The six hospitals used the Mayo telemedicine service in 77 cases over the three years. More than half of those cases involved the Mayo neonatologists remotely guiding the other physicians in airway management, chest compressions, medication dosages, thermoregulation, procedures, identification of congenital anomalies, and palliative care.
In one instance, doctors were able to resuscitate twin girls born at 22 weeks so the parents could spend some time with them, according to Fang.
“To ask a family doctor to do this on their own is really asking them to do the impossible,” she said. “But having a neonatologist there to guide them step by step allowed these babies to survive.”
One-third of the cases resulted in the newborn remaining in the hospital of birth, avoiding costly medical transport and admission to the intensive care unit. Nearly 95 percent of participating providers said that they would use the service again and found it quite helpful.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
There was one snag, however. The team abandoned the wireless, tablet-based, video-conferencing software it started the study with because of poor connectivity and unreliability of the wireless system. They defaulted to a cart-based, hard-wired solution that may be brought to the patient’s bedside, which offered significant advantages, Fang said.
Photo: Flickr user Joshua Smith
