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

Abstract

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.

Emergency Video Telemedicine Consultation for Newborn Resuscitations

“…Although this study did not specifically address the validity of video assessment, evidence suggests that with the appropriate telemedicine technologies, high levels of agreement between bedside and remote physicians can be achieved on multiple physical examination findings, including genetic and neurologic examinations. 14,15 Because of the poor reliability and audiovideo quality of the technology used in this study, Mayo Clinic has transitioned the emergency telemedicine platform for newborn resuscitations to a wired solution. Local teams now use a wired telemedicine cart that is equipped with a high-definition camera with pan/tilt/zoom capabilities that can be remotely controlled by the neonatologist.…”

The Impact of Telemedicine Intensivist Support and a Pediatric Hospitalist Program on a Community Hospital

“…4,10,11 It has also been shown that telemedicine evaluation has good concordance with in-person evaluation of pediatric patients. 12,13 However, the effectiveness of telemedicine systems for pediatric critical care evaluation has not been thoroughly assessed.…”

Remote Patient Monitoring and Telemedicine in Neonatal and Pediatric Settings: Scoping Literature Review (Preprint)

“…116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 Additionally, the video screen is able to move as the physician or neonatal care specialist requires to care for patients. A digital stethoscope, otoscope, and pulse oximeter allow the physician to check vital signs, listen to heart and bowel sounds, and better evaluate the patient while in a remote location [15][16]. By working together with on-site nurses, off-site neonatal providers are able to maneuver the RTP machine on their own from a distant location, and motion sensors keep the machine from bumping into any incubators or medical equipment.…”

“…Robotic telepresence is a form of telemedicine that allows face-to-face contact between a specialist and a patient in a hospital [15][16]. An increase in preterm deliveries and an increase in survival rates with advances in neonatal medicine have resulted in a need for neonatal intensive care units (NICUs) to staff more neonatal specialists during more hours of the day [17].…”

“…Garingo et al [15] studied the ability of on-site and off-site neonatologists to physically examine patients in the NICU, and found that the local and remote physicians had good or excellent agreement for most assessments of patients. Rincon et al's [16] findings showed that NICU nurses felt that physicians were easily accessible via RTP, and that they were adequately involved and supportive of both nurses and NICU patients and their families.…”