Jolene Huey1, Joshua Kang2, Brooke Ellison3
1University of California Berkeley, CA 94720, 2United States Naval Academy, Annapolis, MD 21402, 3Center for Compassionate Care, Medical Humanities, and Bioethics, Health Science Center, Stony Brook University, Stony Brook, NY 11794
*Editors: Lillian Sun, Junsang Yoon, Jessica Guo
Preterm birth is the leading cause of death for children under five years of age; about 15 million babies are born preterm each year.[1] The Neonatal Intensive Care Unit (NICU) serves to combat complications and risks that often result from early births. However, the NICU admits a significantly larger percentage of babies born preterm, with a gestational age less than 37 weeks, than those born full term, with a gestational age between 37 and 41 weeks (Fig. 1).[1] The location restrictive nature of NICUs creates financial strain and psychological distress for parents, especially those in suburban and rural locations. Furthermore, underserved populations are significantly affected by the scarcity of NICUs. Babies born in these areas are more likely to require transfer to hospitals that can accommodate advanced treatment, which increases their chance of fatality. The implementation of telehealth helps alleviate these problems for parents and newborns– specifically for suburban, rural, and underserved populations.
Existing studies on the impact of newborn telehealth on suburban and rural locations find effective telecommunication to be more beneficial than face-to-face interventions, depending on the case. These advantages can be translated to guardians who are distanced from their newborns in care; they contribute to cost savings, promote parental roles, and encourage transparent communication.
In emergencies when certain hospitals are not equipped to give dedicated treatments, newborns are limited to consulting with specialized doctors through telephone calls or waiting for a neonatal transport team, which is risky. Telehealth strengthens doctors’ abilities to give sound medical advice remotely without having to further risk the newborn’s unstable condition by attempting a hospital transfer. Neonatologists can be brought virtually to the bedside and give synchronous treatment such as video-assisted resuscitation.
Despite the strengths that telehealth brings to neonatology, obstacles in existing newborn telehealth programs prevent the up-scaling of telehealth programs in the previously described populations. For instance, the lack of reimbursement for healthcare providers and hospitals is discouraging, warranting the need for policy changes. Considering that newborn monitoring via telehealth was only established in the early 2010s, more data collection is necessary to effectively address these issues. Further research on this subject aims to mitigate one of the largest problems regarding the NICU, family formation, through early discharge and remote monitoring.[2]
References
[1] March of Dimes Perinatal Data Center. Special Care Nursery Admissions. https://www.marchofdimes.org/peristats/pdfdocs/nicu_summary_final.pdf. Published 2011.
[2] Garne, Kristina et al. “Telemedicine in Neonatal Home Care: Identifying Parental Needs Through Participatory Design.” JMIR research protocols vol. 5,3 e100. 8 Jul. 2016, doi:10.2196/resprot.5467