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Updated: Sep 3, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Examining early intervention referral patterns in neonatal intensive care unit follow up clinics using telemedicine
Kerry Miller1, Grace Berentson2, Holly Roberts1
1University of Nebraska Medical Center, Omaha, NE, United States.
Insights
Telemedicine NICU follow-up visits are effective for monitoring infant health and development. Caregiver satisfaction was high, and referral rates were comparable to in-person visits, demonstrating telemedicine
Area of Science:
- Neonatal care
- Telemedicine
- Public health
Background:
- Neonatal intensive care unit (NICU) follow-up programs monitor infant health post-discharge.
- The COVID-19 Public Health Epidemic disrupted in-person NICU follow-up visits.
Purpose of the Study:
- Examine telemedicine use in NICU follow-up clinics.
- Compare referral rates for developmental evaluations between telemedicine and in-person visits.
- Assess telemedicine's future implementation for family access and caregiver satisfaction.
Main Methods:
- Retrospective analysis of clinical records from a state's NICU follow-up program.
- Compared referral patterns and caregiver satisfaction before and during the COVID-19 PHE.
- Included 658 NICU follow-up visits (384 in-person, 274 telemedicine).
Main Results:
- Significantly more medically related referrals were made during telemedicine visits (p < .05).
- No significant difference in educationally based referrals between telemedicine and in-person visits (p > .05).
Conclusions:
- Telemedicine and in-person NICU follow-up resulted in comparable referral rates.
- Caregivers reported high satisfaction with telemedicine visits.
- Virtual NICU follow-up is time- and cost-effective, and effective for identifying referral needs.
Background:
Neonatal intensive care unit (NICU) follow up programs are in place to ensure infant health and development are monitored after discharge. The COVID-19 Public Health Epidemic (PHE) negatively impacted the ability to conduct in-person NICU follow up visits.
Aims:
This study examines using telemedicine in NICU follow up clinics and compares the rates of referral for further medical and/or educational developmental evaluation. A second objective of the study examines if telemedicine can be implemented in the future to ensure access to families while maintaining high levels of caregiver satisfaction.
Method:
Data were obtained retrospectively from clinical records from one state's NICU follow-up program. Patterns of referral for further developmental evaluation and caregiver satisfaction prior to the COVID-19 PHE and during the first year of the COVID-19 PHE were examined. A total of 658 NICU follow up visits (384 in-person and 274 telemedicine) were included.
Results:
Chi Square analyses revealed significantly more medically related referrals were made during telemedicine visits compared to in-person visits, χ2 (1) = 5.55, p .05. There were no significant differences between the clinic types in the number of educationally based referrals made, χ2 (1) = 0.028, p > .05.
Conclusion:
The rates of referral for further evaluation made from in-person and telemedicine clinics were comparable, and caregivers were highly satisfied with telemedicine clinic visits. NICU follow up via a virtual platform saves time, money and is equally effective or better in identifying the need for referral for further evaluation.
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