Premature birth affects 1 in every 10 babies born in the U.S. and is the largest contributor to infant mortality nationally. Facing the challenge of treating this growing population, along with other critically ill infants, Children's Health in Dallas developed a tele-NICU program. Among the benefits: greater patient access to high-level care at a fraction of the cost. "Families don't have to leave their home and have the confidence of a Level IV NICU if they need it," says Rashmin Savani, M.D., M.B., Ch.B., division director of neonatal-perinatal medicine at Children's Health and professor of pediatrics at the University of Texas Southwestern in Dallas. "We're just the push of a button away from providing that consultation."
Keys to success
Children's Health TeleNICU marked six years since its launch and now provides telemedicine services for nine NICU locations across north Texas. Before the system could go live, the hospital spent two years researching-and eventually working through-a maze of medical, legal, compliance and technology challenges. Benefiting from a wealth of knowledge and experience amassed over the course of those eight years, Savani and his team identified three components they say are crucial for building or improving a program that brings telemedicine into the NICU:
Collaboration. To address the myriad of complex problems inherent with this endeavor, Children's Health established a multi-disciplinary committee to work through issues including HIPAA compliance, physician credentialing, enabling remote access to patient EMRs and securing patient data.
The foundation. The right software is the bedrock on which the program will be built-it must meet the performance, privacy and security standards that suit a hospital's specific needs.
Proper tools. Precision, high-tech tools are necessary for distant neonatologists to conduct thorough virtual exams and provide real-time input to clinicians. For Children's Health, they include digital otoscopes and stethoscopes, high-resolution cameras and a video laryngoscope. "We spent an enormous amount of time making sure we had all the peripheral devices we needed, and that's made our program very successful," Savani says.
Savani suggests assessing your needs and making deliberate decisions-don't rush into building a program that brings telemedicine into the NICU. "We were eager to start the program," he says. "But when we looked at everything we needed to do, we knew it would be better to be comprehensive rather than quick."
Beyond patient care
Tele-NICU enables the entire care team, on both ends of the connection, to put the patient's needs first. Primary among those benefits is keeping patients close to home. Children's Health's TeleNICU has conducted more than 200 virtual exams on infants with a variety of diagnoses. As a result, about half of those patients were able to remain in their home hospital Level II and III NICUs instead of transferring to Children's Health in Dallas. Savani says his team also uses the technology to provide lectures and simulations to instill best practices for complicated procedures. "The teaching part of it is important for us."