When people think of a typical telemedicine scenario, they often picture a patient who can’t get to a hospital. A soldier wounded in the field, an elderly man with mobility challenges or a melanoma patient in a rural town hours from a dermatology clinic: these are the usual faces of virtual health. So when some people hear of neonatal applications in telemedicine, they’re often surprised. After all – most infants are born in hospitals, right?
In fact, many hospitals and obstetricians are using telemedicine to ensure each new baby gets the healthiest start possible in life. Consider that:
- 15 percent of pregnant American women receive inadequate or no prenatal care.
- Less than half of pregnant women in developing nations receive sufficient prenatal care.
- 15 million babies are born preterm each year – and the number is rising.
- Preterm birth complications are the leading cause of death among children under 5 – but 75 percent of these deaths could be prevented with timely medical intervention.
The need for better neonatal care is not just obvious, but urgent.
Immediate Intervention When It Matters Most
Telemedicine can bring faster and more advanced care to both pregnant women and infants in several ways.
Many obstetricians are using telemedicine during their patients’ pregnancies to monitor their weight, blood pressure and general condition while reducing the expectant mother’s number of office trips. Women with low-risk pregnancies can even do urine analysis at home and report the results to their providers. However, virtual health can also help providers monitor higher-risk pregnancies and recommend behavioral or environmental changes when they can do the most good.
Similarly, telehealth can also assist with perinatal care and postpartum depression (PPD). One in nine women develop PPD after giving birth but many feel too overwhelmed by caring for their new baby to make appointments, especially when their baby is premature or struggling with an illness. Telemedicine can connect them to behavioral healthcare services such as talk therapy or medication when and where it’s convenient for them. It can also help them improve their nutrition or manage chronic conditions like hypertension before their next pregnancy.
But telehealth’s most dramatic benefits come in what neonatologists call the “Golden Hour” – the first hour of post-natal life. Evidence-based intervention in those first sixty minutes can improve long-term outcomes for these fragile patients. Interventions include resuscitation, post-resuscitation care, transportation to a neonatal intensive care unit and respiratory and cardiovascular support. Studies have shown the Golden Hour approach in preterm neonates can drive marked reduction in hypothermia, hypoglycemia, intraventricular hemorrhage, bronchopulmonary dysplasia, and retinopathy of prematurity.
In other words – immediacy is everything when it comes to treating a newborn in need. And nothing delivers immediacy like telemedicine.
By increasing access to neonatal specialists, telehealth can reduce the number of unnecessary neonatal transfers and provide immediate expertise. Whether addressing a complicated delivery or treating a newborn with a low Apgar respiration score, onsite providers can work with remote neonatologists to stabilize the patient. Babies are also more likely to stay in their community hospital, close to their parents.
Virtual health modalities can also improve care coordination – something vital considering the range of providers that can be involved in neonatal care. With pediatric residents, lactation consultants, dieticians, neonatal nurse practitioners, respiratory and speech therapists and other professionals providing services, telemedicine can clarify communication and share real-time updates with both parents and providers.
Loyola Innovation Saves Lives
One example of a virtual neonatal program is Loyola University Medical Center, a nationally renowned healthcare facility. The facility’s Ronald McDonald Children's Hospital is a hospital within a hospital that includes neonatal and pediatric intensive care units. To provide faster critical care in life-threatening cases, Loyola launched a telemedicine program that could offer real-time services – no matter where physicians were located. Using state-of-the-art virtual care solutions from GlobalMed, their staff have been able to improve clinical outcomes and save infant lives.
The program offers multiple benefits. As an academic medical center, Loyola has a mix of residents, medical students, senior attending physicians and faculty on staff. With only one attending physician typically present in the unit, both residents and physicians can feel intense pressure in urgent cases. Telemedicine helps relieve that pressure by letting neonatologists and ICU attending physicians evaluate and treat patients in real time from wherever they may be.
To do so, the Loyola team moves portable GlobalMed carts from bed to bed, instead of having to move infants to hardwired exam rooms. Using HD video monitors, cameras and connective devices, staff can connect with attending physicians and neonatal specialists to monitor vital signs, ask questions, validate diagnoses, examine x-rays together and have the doctors observe treatment progress – without requiring more specialist and attending physician presence onsite. In one notable case, a physician received a call about an arresting patient when she was still 20 minutes from the hospital. She connected to the mobile cart at the patient’s bed, evaluated the patient and began directing critical care immediately until the patient was stabilized – something that couldn’t have waited 20 minutes.
Since their early success in the ICU, Loyola expanded their program to address pediatric emergency situations and code events in non-ICU settings, including the emergency room. The mortality rate of children who are admitted to the ward or stepdown unit and subsequently transferred to the ICU is now zero percent.
New Care Models for New Lives
Telemedicine can offer a vital lifeline for healthcare’s tiniest patients. Its ability to offer immediate specialized medicine can not only elevate care delivery across a neonatal unit but create a healthier foundation for every baby’s future. With the number of preterm births on the rise, it’s time for every hospital and clinic to put virtual innovation in the service of saving new lives.