Abhishek Makkar1, R Michael Siatkowski2, Edgardo Szyld1, Abhrajit Ganguly1, Kris Sekar1
1. Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States;
2. Department of Ophthalmology, Dean McGee Eye Institute, Oklahoma City, OK, United States
Scope of telemedicine in neonatology
Abhishek Makkar1, R Michael Siatkowski2, Edgardo Szyld1, Abhrajit Ganguly1, Kris Sekar1
1. Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States;
2. Department of Ophthalmology, Dean McGee Eye Institute, Oklahoma City, OK, United States
There is a widespread shortage of physicians worldwide, especially in rural areas. This shortage is more prevalent when it comes to subspecialty care, even in developed countries. One way to provide access to specialty care is using technology via telemedicine. Telemedicine has evolved over the last two decades, and its use is becoming widespread in developed countries. However, its use in the neonatal population is still limited and practiced only in some centers. It is now apparent that telemedicine can be successfully used in the neonatal population for screening premature infants for retinopathy of prematurity, congenital heart disease, bedside clinical rounds, neonatal resuscitation with the support of a tertiary care hospital, and family support. This avoids unnecessary transfer and appears to provide the same quality of care that the baby would have received at the tertiary care facility. This approach also improves family satisfaction, as the baby and the mother are kept together, and reduces the cost of care. This review focuses on the use of telemedicine in neonatal care, concentrating on the main areas where telemedicine has been shown to be successful and effective, including the status of telemedicine in China.
Abstract:There is a widespread shortage of physicians worldwide, especially in rural areas. This shortage is more prevalent when it comes to subspecialty care, even in developed countries. One way to provide access to specialty care is using technology via telemedicine. Telemedicine has evolved over the last two decades, and its use is becoming widespread in developed countries. However, its use in the neonatal population is still limited and practiced only in some centers. It is now apparent that telemedicine can be successfully used in the neonatal population for screening premature infants for retinopathy of prematurity, congenital heart disease, bedside clinical rounds, neonatal resuscitation with the support of a tertiary care hospital, and family support. This avoids unnecessary transfer and appears to provide the same quality of care that the baby would have received at the tertiary care facility. This approach also improves family satisfaction, as the baby and the mother are kept together, and reduces the cost of care. This review focuses on the use of telemedicine in neonatal care, concentrating on the main areas where telemedicine has been shown to be successful and effective, including the status of telemedicine in China.
Aluttis C, Bishaw T, Frank MW. The workforce for health in a globalized context-global shortages and international migration[J]. Glob Health Action, 2014, 7:23611.
[2]
Association of American Medical Colleges. 2019 update:the complexities of physician supply and demand:projections from 2017 to 2032[EB/OL].[March 13, 2020]. https://aamc-black.global.ssl.fastly.net/production/media/filer_public/31/13/3113ee5c-a038-4c16-89af-294a69826650/2019_update_-_the_complexities_of_physician_supply_and_demand_-_projections_from_2017-2032.pdf.
[3]
Association NRH. About rural health care[EB/OL].[March 13, 2020]. https://www.ruralhealthweb.org/about-nrha/about-ruralhealth-care#_ftn1.
[4]
Health C. Types of telemedicine[EB/OL].[March 13, 2020]. https://chironhealth.com/definitive-guide-to-telemedicine/abouttelemedicine/types-of-telemedicine/.
[5]
Association AT. Telehealth basics[EB/OL].[March 13, 2020]. https://www.americantelemed.org/resource/why-telemedicine/.
[6]
Hoffman AM, Lapcharoensap W, Huynh T, et al. Historical perspectives:telemedicine in neonatology[J]. Neoreviews, 2019, 20(3):e113-e123.
[7]
Olson CA, McSwain SD, Curfman AL, et al. The current pediatric telehealth landscape[J]. Pediatrics, 2018, 141(3). pii:e20172334.
[8]
Graham E Quinn; e-ROP Cooperative Group. Telemedicine approaches to evaluating acute-phase retinopathy of prematurity:study design[J]. Ophthalmic Epidemiol, 2014, 21(4):256-267.
[9]
Quinn GE, Ying GS, Daniel E, et al. Validity of a telemedicine system for the evaluation of acute-phase retinopathy of prematurity[J]. JAMA Ophthalmol, 2014, 132(10):1178-1184.
[10]
Quinn GE, Ying GS, Repka MX, et al. Timely implementation of a retinopathy of prematurity telemedicine system[J]. J AAPOS, 2016, 20(5):425-430.e1.
[11]
Binenbaum G, Tomlinson LA, de Alba Campomanes AG, et al. Validation of the postnatal growth and retinopathy of prematurity screening criteria[J]. JAMA Ophthalmol, 2019, 138(1):31-37.
[12]
Quinn GE, Vinekar A. The role of retinal photography and telemedicine in ROP screening[J]. Semin Perinatol, 2019, 43(6):367-374.
[13]
Quinn GE, Ying GS, Pan W, et al. Detection of potentially severe retinopathy of prematurity by remote image grading[J]. JAMA Ophthalmol, 2017, 135(9):982-986.
[14]
Isaac M, Isaranuwatchai W, Tehrani N. Cost analysis of remote telemedicine screening for retinopathy of prematurity[J]. Can J Ophthalmol, 2018, 53(2):162-167.
[15]
Makkar A, McCoy M, Sekar K, et al. Utility of telemedicine for retinopathy of prematurity examination in level II NICU[J]. J Okla State Med Assoc, 2018, 111(5):610-613.
[16]
Makkar A, McCoy M, Siatkowski M. Use of telemedicine for retinopathy of prematurity examination in a level II NICU[J]. J Investig Med, 2020, 68(2):435-710.
[17]
Liu Y, Chen S, Zühlke L, et al. Global birth prevalence of congenital heart defects 1970-2017:updated systematic review and meta-analysis of 260 studies[J]. Int J Epidemiol, 2019, 48(2):455-463.
[18]
Mahle WT, Newburger JW, Matherne GP, et al. Role of pulse oximetry in examining newborns for congenital heart disease:a scientific statement from the AHA and AAP[J]. Pediatrics, 2009, 124(2):823-836.
[19]
Oster ME, Lee KA, Honein MA, et al. Temporal trends in survival among infants with critical congenital heart defects[J]. Pediatrics, 2013, 131(5):e1502-e1508.
[20]
Sable C. Digital echocardiography and telemedicine applications in pediatric cardiology[J]. Pediatr Cardiol, 2002, 23(3):358-369.
[21]
Sable C, Roca T, Gold J, et al. Live transmission of neonatal echocardiograms from underserved areas:accuracy, patient care, and cost[J]. Telemed J, 1999, 5(4):339-347.
[22]
Sable CA, Cummings SD, Pearson GD, et al. Impact of telemedicine on the practice of pediatric cardiology in community hospitals[J]. Pediatrics, 2002, 109(1):E3.
[23]
Grant B, Morgan GJ, McCrossan BA, et al. Remote diagnosis of congenital heart disease:the impact of telemedicine[J]. Arch Dis Child, 2010, 95(4):276-280.
[24]
Webb CL, Waugh CL, Grigsby J, et al. Impact of telemedicine on hospital transport, length of stay, and medical outcomes in infants with suspected heart disease:a multicenter study[J]. J Am Soc Echocardiogr, 2013, 26(9):1090-1098.
[25]
Milsten JPK, McCoy M, Makkar A. Utility of telemedicine for screening congenital heart disease in a level II NICU[J]. J Investig Med, 2020, 68(2):435-710.
[26]
Colombo JN, Seckeler MD, Barber BJ, et al. Application and utility of iPads in pediatric tele-echocardiography[J]. Telemed J E Health, 2016, 22(5):429-433.
[27]
Dooley SL, Freels SA, Turnock BJ. Quality assessment of perinatal regionalization by multivariate analysis:Illinois, 1991-1993[J]. Obstet Gynecol, 1997, 89(2):193-198.
[28]
Gortmaker S, Sobol A, Clark C, et al. The survival of very lowbirth weight infants by level of hospital of birth:a population study of perinatal systems in four states[J]. Am J Obstet Gynecol, 1985, 152(5):517-524.
[29]
American Academy of Pediatrics Committee on Fetus and Newborn. Levels of neonatal care[J]. Pediatrics, 2012, 130(3):587-597.
[30]
Lorch SA, Baiocchi M, Ahlberg CE, et al. The differential impact of delivery hospital on the outcomes of premature infants[J]. Pediatrics, 2012, 130(2):270-278.
[31]
Brantley MD, Davis NL, Goodman DA, et al. Perinatal regionalization:a geospatial view of perinatal critical care, United States, 2010-2013[J]. Am J Obstet Gynecol, 2017, 216(2):185.e1-185.e10.
[32]
Fang JL, Carey WA, Lang TR, et al. Real-time video communication improves provider performance in a simulated neonatal resuscitation[J]. Resuscitation, 2014, 85(11):1518-1522.
[33]
Fang JL, Campbell MS, Weaver AL, et al. The impact of telemedicine on the quality of newborn resuscitation:a retrospective study[J]. Resuscitation, 2018, 125:48-55.
[34]
Albritton J, Maddox L, Dalto J, et al. The effect of A newborn telehealth program on transfers avoided:a multiple-baseline study[J]. Health Aff (Millwood), 2018, 37(12):1990-1996.
[35]
Beck JA, Jensen JA, Putzier RF, et al. Developing a newborn resuscitation telemedicine program:a comparison of two technologies[J]. Telemed J E Health, 2018, 24(7):481-488.
[36]
McCauley K, Kreofsky BL, Suhr T, et al. Developing a newborn resuscitation telemedicine program:a follow-up study comparing two technologies[J]. Telemed J E Health, 2019, 14. DOI:10.1089/tmj.2018.0319. Epub ahead of print.
[37]
Fang JL, Asiedu GB, Harris AM, et al. A mixed-methods study on the barriers and facilitators of telemedicine for newborn resuscitation[J]. Telemed J E Health, 2018, 24(10):811-817.
[38]
Rosenfeld BA, Dorman T, Breslow MJ, et al. Intensive care unit telemedicine:alternate paradigm for providing continuous intensivist care[J]. Crit Care Med, 2000, 28(12):3925-3931.
[39]
Nadar M, Jouvet P, Tucci M, et al. Impact of synchronous telemedicine models on clinical outcomes in pediatric acute care settings:a systematic review[J]. Pediatr Crit Care Med, 2018, 19(12):e662-e671.
[40]
Garingo A, Friedlich P, Chavez T, et al. "Tele-rounding" with a remotely controlled mobile robot in the neonatal intensive care unit[J]. J Telemed Telecare, 2016, 22(2):132-138.
[41]
Makkar A, McCoy M, Hallford G, et al. A hybrid form of telemedicine:a unique way to extend intensive care service to neonates in medically underserved areas[J]. Telemed J E Health, 2018, 24(9):717-721.
[42]
Garingo A, Friedlich P, Tesoriero L, et al. The use of mobile robotic telemedicine technology in the neonatal intensive care unit[J]. J Perinatol, 2012, 32(1):55-63.
[43]
McCoy M, Makkar A, Foulks A, et al. Establishing level II neonatal services in southwestern Oklahoma[J]. J Okla State Med Assoc, 2014, 107(9-10):493-496.
[44]
Makkar A, McCoy M, Hallford G, et al. Evaluation of neonatal services provided in a level II NICU utilizing hybrid telemedicine:a prospective study[J]. Telemed J E Health, 2020, 26(2):176-183.
[45]
Gray J, Pompilio-Weitzner G, Jones PC, et al. Baby CareLink:development and implementation of a WWW-based system for neonatal home telemedicine[J]. Proc AMIA Symp, 1998:351-355.
[46]
Gray JE, Safran C, Davis RB, et al. Baby CareLink:using the internet and telemedicine to improve care for high-risk infants[J]. Pediatrics, 2000, 106(6):1318-1324.
[47]
Holm KG, Clemensen J, Brødsgaard A, et al. Growth and breastfeeding of preterm infants receiving neonatal telehomecare compared to hospital-based care[J]. J Neonatal Perinatal Med, 2019, 12(3):277-284.
[48]
Garne Holm K, Brødsgaard A, Zachariassen G, et al. Parent perspectives of neonatal tele-homecare:a qualitative study[J]. J Telemed Telecare, 2019, 25(4):221-229.
[49]
Wang Z, Gu H. A review of telemedicine in China[J]. J Telemed Telecare, 2009, 15(1):23-27.
[50]
Xue Y, Liang H. Analysis of telemedicine diffusion:the case of China[J]. IEEE Trans Inf Technol Biomed, 2007, 11(2):231-233.
[51]
Pan J, Lu Y, Pan L, et al. Value of long-distance fetal heart rate monitoring on the pre-partum health care of the pregnant woman with umbilical cord loops[J]. Zhonghua Fu Chan Ke Za Zhi, 2002, 37(8):451-454.
[52]
Qi H, Sun J, Liu J, et al. Clinical value of remote fetal monitoring network in high-risk pregnancy[J]. Zhonghua Fu Chan Ke Za Zhi, 2002, 37(8):455-458.
[53]
Su F, Guo X. Clinical application of the expert type terminal of remote electronic fetal heart rate home monitoring system[J]. Zhonghua Fu Chan Ke Za Zhi, 2002, 37(8):459-461.
[54]
Xu S, Liang Z, Du Q, et al. A systematic study on the prevention and treatment of retinopathy of prematurity in China[J]. BMC Ophthalmol, 2018, 18(1):44.
[55]
Zhang X, Wang Y, Ulrich JN, et al. Evaluation of retinopathy of prematurity incidence with telemedicine confirmation in Gansu, China:a pilot study[J]. Ophthalmic Epidemiol, 2018, 25(2):120-125.