Jordan Albritton (
Lory Maddox is clinical manager of Connect Care Pro-Pediatrics in the Telehealth Services Department, Intermountain Healthcare, in Midvale.
Health Aff (Millwood). 2018 Dec;37(12):1990-1996. doi: 10.1377/hlthaff.2018.05133.
Clinicians who rarely perform neonatal resuscitation exhibit skill deterioration. Telehealth addresses this challenge by facilitating video connections between neonatologists at tertiary care centers and providers at smaller hospitals. However, there is little empirical evidence about the benefits of telehealth programs for neonatal resuscitation. Thus, we conducted a multiple-baseline study to evaluate the effect of video-assisted resuscitation on the transfer of newborns from eight community hospitals that implemented neonatal telehealth in the period November 2014-December 2015 to level 3 newborn intensive care units. The intervention was associated with a reduction of 0.70 transfers per facility-month and a 29.4 percent reduction in a newborn's odds of being transferred. Annually, this corresponds to 67.2 fewer transfers and an estimated savings of $1,220,352 per year. Avoiding transfers keeps families closer to home, increases community hospital revenue, and eliminates transfer-associated risk. Yet lack of reimbursement for telehealth limits its adoption. Policy changes are necessary to align payment incentives and promote the use of telehealth services.
很少进行新生儿复苏操作的临床医生会表现出技能下降。远程医疗通过在三级保健中心的新生儿科医生和较小医院的提供者之间建立视频连接来解决这一挑战。然而，关于远程医疗计划对新生儿复苏的益处的实证证据很少。因此，我们进行了一项多基线研究，以评估视频辅助复苏对 2014 年 11 月至 2015 年 12 月期间实施新生儿远程医疗的 8 家社区医院向 3 级新生儿重症监护病房转院新生儿的影响。该干预措施与每个机构每月减少 0.70 次转院和新生儿转院几率降低 29.4%有关。每年可减少 67.2 次转院，估计每年可节省 1220352 美元。避免转院可使家庭更接近家庭，增加社区医院的收入，并消除与转院相关的风险。然而，远程医疗缺乏报销限制了其采用。需要政策变革来调整支付激励措施并促进远程医疗服务的使用。
