Lowery Curtis, Bronstein Janet, McGhee Judith, Ott Rachel, Reece E Albert, Mays Glen P
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Am J Obstet Gynecol. 2007 Jun;196(6):534.e1-9. doi: 10.1016/j.ajog.2007.01.027.
This article describes the process by which the Arkansas Medicaid Program, the University of Arkansas for Medical Sciences (the state's only academic health center), and Arkansas' practicing physicians are collaborating to improve the process of perinatal regionalization by providing access to expertise, education, and support of maternal-fetal medicine specialists. The described ANGELS model encourages replication among other programs that wish to improve perinatal regionalization attempts in their service areas.
Through this unique collaboration, ANGELS is composed of 5 distinctive elements: a statewide telemedicine and clinic network, an education and support program for obstetric providers, case management services, a 24-hour Call Center, and an evidence-based guidelines development and distribution network.
Since Arkansas has undertaken perinatal regionalization, technology has allowed the state's only group of board-certified maternal-fetal medicine specialists, located centrally in Little Rock, to provide real-time clinical support to physicians, as well as consultation or direct care to patients statewide.
ANGELS' continued efforts have the potential to significantly improve perinatal care in rural areas throughout the state, while the cost of maternal and fetal health care could decline. The program's design, although unique, can be replicated elsewhere to encourage perinatal regionalization.
本文描述了阿肯色州医疗补助计划、阿肯色大学医学科学分校（该州唯一的学术健康中心）以及阿肯色州执业医师通过提供母胎医学专家的专业知识、教育和支持来合作改善围产期区域化进程的过程。所描述的ANGELS模式鼓励其他希望改善其服务区域内围产期区域化尝试的项目进行效仿。
通过这种独特的合作，ANGELS由5个独特要素组成：一个全州范围的远程医疗和诊所网络、一个针对产科医疗服务提供者的教育和支持项目、病例管理服务、一个24小时呼叫中心以及一个基于证据的指南制定和分发网络。
自从阿肯色州开展围产期区域化以来，技术使该州唯一一组位于小石城中心的获得委员会认证的母胎医学专家能够为全州的医生提供实时临床支持，并为患者提供咨询或直接护理。
ANGELS的持续努力有可能显著改善全州农村地区围产期护理，同时母婴保健成本可能会下降。该项目的设计虽然独特，但可以在其他地方复制以鼓励围产期区域化。
