A 360 Evaluation of Neonatal Care Quality at a Level II Neonatal Intensive Care Unit when Delivered Using a Hybrid Telemedicine Service

Abstract

Background: In 2013, the Section of Neonatal and Perinatal Medicine at the University of Oklahoma’s Children’s Hospital began providing advanced care to a regional Level II NICU, using a hybrid telemedicine program. Objective: This project compares healthcare providers’ and parents’ assessment of healthcare quality using this program. Study Design: A prospective, anonymous, non-randomized survey of healthcare providers and parents of neonates using our hybrid telemedicine services. Physicians, neonatal nurse practitioners, nurses, and parents completed pencil-and-paper surveys based on their participatory role. IRB approval was obtained at OU Medical Center and Comanche County Memorial Hospital. Surveys consisted of five-point Likert scale questions. Descriptive statistics compared level of agreement with each question across participant groups. A service quality (SQ) composite score was created by summing responses from six service quality questions. Between-group analysis was done on the SQ score using Mann Whitney U test. Results: Nine physicians, 10 NNPs, 12 Nurses, and 40 parents completed the survey. Providers. Providers agreed (90%) that telemedicine can effectively deliver advanced neonatal care; the care patients receive is comparable to direct patient care (87%); telemedicine enhanced overall patient care quality (90%); providers can effectively interact with each other and families using telemedicine (90.3%), and overall telemedicine experience was good (90%). 61% of providers reported telemedicine improves physician-patient interaction. Parents. Parents of newborns agreed they were well informed about telemedicine use for their child’s care (88%); were able to communicate routinely with neonatologists (85%); and were comfortable with their child’s physical exams (93%). Provider’s vs family’s (SQ) score was not significantly different. Conclusion: All survey participants, including neonatologists, NNPs, nurses and patient families, reported high levels of satisfaction with the hybrid telemedicine model developed and implemented at this institution, which may be comparable to in-person direct patient care.