TeleNICU Offers High-Value Care to Tiniest Patients
As a leading pediatric health system in North Texas, Children’s Health strives to provide the right care at the right place at the right time to best align our resources with the needs of our patients and their families. As we contemplated our mission to make life better for children, it was clear that our efforts must include a telemedicine program designed specifically to help the tiniest pediatric patients—those who need neonatal intensive care unit (NICU) care.
In the summer of 2013, our organization launched the TeleNICU program with a hospital located more than 90 miles away. The program has grown rapidly and been so well-received that we are expanding it to 25 additional hospitals.
Through the TeleNICU program, Level-IV NICU board-certified neonatologists at Children’s Health use dedicated video-conferencing equipment and specialty instrumentation to interact with and examine NICU patients at remote hospitals. Caregivers at an outlying hospital can conduct a full exam within their own environment while our neonatologist participates interactively from the TeleNICU studio located on the Children’s Health campus in Dallas.
The TeleNICU equipment is designed so that the instrumentation used for exams on-site can transmit telemetry information back to our experts; all data is secured and encrypted at rest and in transit. This technology allows physicians to share information during examinations in real time, greatly improving the speed at which a diagnosis or transfer decision can be made.
If the child’s condition warrants a transfer to a Level-IV NICU and the neonatologist decides the patient should be brought to our hospital, Children’s Medical Center Dallas, the experience is easier because of the TeleNICU connection. Parents have “virtually” met the neonatologists during the consultation in their home hospital and are familiar with the physicians who work in our NICU. In addition, length of stay is typically reduced and the outcomes tend to be better because Level-IV interventional strategies have been delivered while the baby was in his or her home hospital.
Moreover, a major benefit of TeleNICU is that more babies can remain in their home hospitals, eliminating the costly and disruptive transfer to a Level-IV NICU. In developing the TeleNICU program, we studied patient transfers from several hospitals with Level-III NICUs and determined that a number of those babies could have remained at their home hospital had we been able to provide the kind of support that is now available through the TeleNICU program. The TeleNICU program thus eliminates unnecessary transfers, ensuring that a transfer occurs only when treatment at a tertiary facility is essential.
A hospital’s initial cost to use our TeleNICU program is minimal; a single piece of equipment is all that is needed. As per the recommendation from the American Telemedicine Association, our organization bills a nominal service fee each month for 24/7/365 coverage for the hospital’s NICU patients instead of a “pay per click” usage fee.
The Children’s Health TeleNICU program was named a 2013 semifinalist for the Innovator Award presented by Healthcare Informatics. The program was presented at the 2014 American Hospital Association Health Forum Leadership Conference as one of the leading strategies for promoting high-value health care by providing higher-quality care at lower costs.
In addition, Children’s Health was recognized by Hospitals & Health Networks in its 2014 Most Wired list for our TeleNICU program and was among the 2015 InformationWeek Elite 100 winners.
These honors affirm that the TeleNICU concept is a value-oriented strategy that connects our resources with the families who need them in a cost-effective way. Most importantly, it advances the mission that has guided our work since 1913: to make life better for children.
Mitch Hall is manager, Virtual Health and Innovation, Children’s Health, Dallas. Read more entries on the Leadership Blog.