Early experience using telemedicine for neonatal surgical consultations

Robie, Daniel K.; Naulty, Cheryl M; Parry, Robert L.; Motta, Camille A.; Darling, Bryan; Micheals, Marshall R.; Poropatich, Ronald K.; Gomez, Eward R

doi:10.1016/s0022-3468(98)90554-1

Cited by 33 publications

(19 citation statements)

References 8 publications

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“…The first and simplest form uses tele-or videoconferencing to enable direct interaction between the patient and/or the patient's primary care provider and a specialist who is at a different physical location. This form of telemedicine has been utilized primarily by large health-care systems to provide services at medically underserved or remote areas involving disciplines such as obstetrics and neonatal-perinatal medicine, 11,13,14 medicine, surgery, pharmacy, nursing and home health care. 1 The second and most common form of telemedicine provides the local physician with interpretation of imaging by a remote expert in different areas such as cardiac electrophysiology and echocardiography, [16][17][18][19][20][21]29,30 radiology 22,28 and ophthalmology.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, the benefits of the use of telemedicine in adult and pediatric intensive care have already been demonstrated. [4][5][6][7][8][9] As for neonatal care, there is a growing body of literature on the use of telemedicine primarily at remote areas for the provision of staff and parent education, [10][11][12] neonatology and other subspecialty consultations 10,[13][14][15] and expert interpretation of echocardiographic [16][17][18][19][20][21] and radiographic 22 images. The findings of some of these studies suggest that the use of telemedicine improves quality of care and parental satisfaction and may decrease healthcare costs and length of hospitalization of neonates requiring intensive care.…”

Section: Introductionmentioning

confidence: 99%

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The use of mobile robotic telemedicine technology in the neonatal intensive care unit

et al. 2011

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Objective: To describe the use of a wireless, mobile, robotic telecommunications system in the Neonatal Intensive Care Unit (NICU).Study Design: In this prospective study utilizing 304 patient encounters on 46 preterm and term neonates in a level IIIa NICU, a bedside neonatologist ('on-site neonatologist'; ONSN) and a neonatologist at a distant location ('off-site neonatologist'; OFFSN) evaluated selected demographic information, laboratory data and clinical and radiological findings of the subjects. The OFFSN used a commercial wireless, mobile, robotic telecommunications system controlled from a remote site. The two physicians were blinded to each other's findings and agreement rates of the evaluations between the ONSN and the OFFSN were compared using kappa statistics. Agreement rates between two ONSNs using the same protocol with 39 patient encounters served as the reference standard. The dependability and timeliness of data transmission were also assessed.Result: Excellent or intermediate-to-good agreements were noted for all but a few physical examination assessments between both the ONSN and OFFSN and the two ONSNs. Poor agreements were found for certain physical examination parameters (breath-, heart-and bowel-sounds and capillary refill time) with or without the use of telemedicine. The median duration of the encounters by the ONSN and OFFSN and the two ONSNs was similar. Five encounters were excluded from the analysis because of technical difficulties. No complications associated with the use of the mobile robot were noted. Conclusion:Our findings indicate that the use of mobile robotic telemedicine technology is feasible for neonates in the NICU.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The use of mobile robotic telemedicine technology in the neonatal intensive care unit

et al. 2011

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“…Studies have demonstrated successful use of telemedicine services such as consultations, diagnoses, and/or treatments to provide adequate perinatal care. 7–15 For example, Robie and colleagues 9 in 1998 demonstrated the efficacious use of telemedicine in providing accurate diagnoses and guidance for surgical consultation in the intensive care nursery. Similarly, women with potentially poor pregnancy outcomes were given diagnoses and guidance via a telemedicine consultation with a perinatologist.…”

Section: Introductionmentioning

confidence: 99%

US and territory telemedicine policies: identifying gaps in perinatal care

Okoroh

Kroelinger

Smith

et al. 2016

American Journal of Obstetrics and Gynecology

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BACKGROUND Perinatal regionalization is a system of maternal and neonatal risk-appropriate health care delivery in which resources are ideally allocated for mothers and newborns during pregnancy, labor and delivery, and postpartum, in order to deliver appropriate care. Typically, perinatal risk-appropriate care is provided in-person, but with the advancement of technologies, the opportunity to provide care remotely has emerged. Telemedicine provides distance-based care to patients by consultation, diagnosis, and treatment in rural or remote US jurisdictions (states and territories). OBJECTIVE We sought to summarize the telemedicine policies of states and territories and assess if maternal and neonatal risk-appropriate care is specified. STUDY DESIGN We conducted a 2014 systematic World Wide Web–based review of publicly available rules, statutes, regulations, laws, planning documents, and program descriptions among US jurisdictions (N=59) on telemedicine care. Policies including language on the topics of consultation, diagnosis, or treatment, and those specific to maternal and neonatal risk-appropriate care were categorized for analysis. RESULTS Overall, 36 jurisdictions (32 states; 3 territories; and District of Columbia) (61%) had telemedicine policies with language referencing consultation, diagnosis, or treatment; 29 (49%) referenced consultation, 30 (51%) referenced diagnosis, and 35 (59%) referenced treatment. In all, 26 jurisdictions (22 states; 3 territories; and District of Columbia) (44%), referenced all topics. Only 3 jurisdictions (3 states; 0 territories) (5%), had policy language specifically addressing perinatal care. CONCLUSION The majority of states have published telemedicine policies, but few specify policy language for perinatal risk-appropriate care. By ensuring that language specific to the perinatal population is included in telemedicine policies, access to maternal and neonatal care can be increased in rural, remote, and resource-challenged jurisdictions.

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“…Although most pediatric studies have centered on outpatient subspecialty services, the use of pediatric cardiology and pediatric surgical evaluations to neonatal units have demonstrated successes. 10,[12][13][14] The development of pediatric ICU-based telemedicine consultative services, similar to the experience we are reporting here, will be part of the evolving ''virtual PICU'' currently under development. 15 In an adult surgical ICU with no full-time intensivist on site, a full-time remote telemedicine program staffed by intensivists was able to achieve reductions in severity-adjusted mortality rates, LOS, and costs.…”

Section: Discussionmentioning

confidence: 56%