Implementing Telemedicine Intervention in Neonatal Intensive Care Units: Augmented Teleconsultation and Real-Time...

Area of Science:

• Neonatal Intensive Care
• Critical Care Medicine
• Telehealth

Background:

• Intensivist shortages and high bed occupancy in NICUs necessitate innovative solutions.
• Tele-critical care (TCC) via teleconsultations offers a promising approach to enhance NICU capacity.
• This study addresses the growing demand for NICU services and the need for improved patient management.

Purpose of the Study:

• To describe the role of TCC intervention in improving NICU discharge, bed occupancy, and neonatal mortality rates.
• To evaluate the effectiveness of a scheduled care TCC model in a public hospital setting.
• To assess the impact of TCC on critical care delivery within the NICU.

Main Methods:

• An uncontrolled, retrospective, interventional descriptive study was conducted over 22 months (Jan 2021-Oct 2022).
• A scheduled care TCC model was implemented, including daily rounds, overnight calls, and on-demand consultations by an intensivist.
• Real-time outcomes (mortality, discharge, bed occupancy) were monitored by the National Healthcare Command Center.

Main Results:

• The TCC program was associated with a 10.7% reduction in the neonatal mortality rate (10.3 to 9.2 deaths per 1000 live births).
• NICU discharge rates increased significantly, from 0% to 34.12% within 4 months of TCC implementation.
• No statistically significant difference in mortality rates was found between pre- and post-TCC implementation (p = 0.856).

Conclusions:

• TCC, utilizing virtual scheduled consultations and a real-time dashboard, successfully managed neonatal mortality and discharge rates.
• The TCC intervention demonstrated effectiveness in enhancing NICU capacity and patient flow.
• Further research is recommended to explore long-term effects, physician acceptance, and broader logistical impacts of TCC.