Bridging the Gap: Subspecialty Telemedicine Consultations at a Level III Neonatal Intensive Care Unit

Area of Science:

• Neonatal Medicine
• Telehealth
• Pediatric Subspecialties

Background:

• Neonatal intensive care units (NICUs) often face challenges accessing subspecialist consultants.
• Existing solutions include patient transfers or informal consultations, which have limitations.

Purpose of the Study:

• To evaluate the feasibility, acceptability, and impact of a teleconsultation service.
• To extend pediatric subspecialty services from a children's hospital to a level III NICU.
• To describe the processes, facilitators, and challenges of implementing such a service.

Main Methods:

• A teleconsultation service was implemented, supporting a level III NICU.
• Fifty-nine monitored consultations were conducted over one year.
• Clinicians were surveyed regarding feasibility, benefits, and challenges.

Main Results:

• The teleconsultation service was feasible and generally acceptable to both NICU providers and subspecialists.
• NICU providers reported improved care quality due to subspecialty input.
• Subspecialists noted benefits in documentation and care completeness, alongside logistical challenges.

Conclusions:

• The teleconsultation service successfully improved access to pediatric subspecialty care for the NICU.
• The initiative enhanced NICU clinicians' perceived quality of care.
• Key challenges included infrastructure costs, training, logistics, and subspecialist workload.