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Updated: Feb 11, 2026

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Home-Based Transcutaneous Bilirubin Screening and Telemedicine Reduce Neonatal Referrals.

Sagee Nissimov1,2, Nili Haas3, Sonia Habib4

  • 1Department of Neonatology, Shamir Medical Center, Zerifin, Israel, sageen@shamir.gov.il.

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|February 9, 2026
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Summary

A new nurse-led home care pathway using transcutaneous bilirubin (TcB) screening and teleconsultation significantly reduced unnecessary neonatal referrals by over 80% without missing any infants needing phototherapy.

Keywords:
Home care servicesNeonatal jaundiceTelemedicineTranscutaneous bilirubin

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Area of Science:

  • Neonatal care
  • Public health
  • Digital health

Background:

  • Neonatal jaundice is a primary cause of post-discharge referrals, often relying on less accurate visual assessments.
  • Current community follow-up methods for neonatal jaundice can lead to avoidable clinic visits.
  • There is a need for scalable, safe home-based pathways for neonatal jaundice management.

Purpose of the Study:

  • To evaluate a nurse-led home pathway integrating transcutaneous bilirubin (TcB) screening with pediatric teleconsultation.
  • To assess the impact of this pathway on reducing unnecessary neonatal referrals post-discharge.
  • To determine the safety and efficiency of this digitally supported home care model.

Main Methods:

  • A prospective before-after study comparing visual assessment with a TcB-guided pathway and teleconsultation.
  • The study included eligible infants (≥35 weeks gestation) within routine nurse-led home visits.
  • Primary analysis focused on infants who would have been referred under usual care, measuring referral reduction.

Main Results:

  • The TcB-guided pathway avoided 81.9% of potential neonatal referrals among eligible infants.
  • Transcutaneous bilirubin screening identified all infants (0.4%) requiring phototherapy within 14 days.
  • The intervention resulted in an absolute decrease of 0.67 visits per infant, indicating improved efficiency.

Conclusions:

  • A nurse-led, digitally supported home pathway effectively reduces unnecessary neonatal referrals.
  • This precision-triage model integrates TcB screening and teleconsultation, maintaining safety by not missing infants requiring phototherapy.
  • The pathway is implementable within existing community services, easing the burden on post-discharge systems.