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Analysis

How Intermountain Saved $1.2M With Neonatal Telehealth Program

By Christopher Cheney  
   December 21, 2018

Avoiding air medical transfers of newborns from community hospitals to tertiary hospitals saves an average of $18,000 per flight.

Intermountain Healthcare's neonatal telehealth service has improved quality of care at community hospitals and reduced risky transfers of critically ill newborns, recent research published in Health Affairs shows.

Earlier studies have shown that 10% of newborns require breathing assistance, and 1% need resuscitation. Although hospital-based clinicians who care for newborns attend biannual newborn resuscitation programs, researchers have found key skills decline within months of course attendance.

Intermountain's neonatal telehealth service provides clinical and educational support at 17 Intermountain facilities and four partner hospitals that do not have neonatologists on staff. The telehealth service provides access to neonatologists based at four Intermountain tertiary hospitals with neonatal intensive care units (NICUs).

This week, a co-author of the Health Affairs research told HealthLeaders that the neonatal telehealth service is a valuable capability at community hospitals.

"We use a synchronous, video connection with bedside teams. These teams provide hands on care for the newborn and may be guided through procedures by the neonatologists. These specialists provide their expertise for newborns that are delivered at rural or community hospitals that were previously not typically managed at these hospitals, but often transported to larger facilities," said Stephen Minton, MD, neonatology medical director at Intermountain's Utah Valley Hospital in Provo.

Minton's research team examined newborn transfer data over a yearlong period at eight hospitals participating in the neonatal telehealth program. The researchers found that the program reduced the odds of a neonatal transfer 29.4%. This figure was associated with an estimated 67 fewer transfers annually and cost savings of $1.2 million.

Avoiding transfer of critically ill babies helps support the financial viability of community hospitals and has clinical benefits such as averting the risk handoff communication errors and high-altitude flights.

The neonatal telehealth program features several services and benefits.

  • For newborns such as premature infants who require transfer to a NICU, neonatologists are available to guide pre-transport stabilization until the specialized neonatal transport team arrives
     
  • Neonatologists, who are familiar with unique newborn physiology and emergency procedures, act as subject matter experts and coach bedside teams for infants who have serious conditions such as infections
     
  • When a need for neonatologist assistance is identified prior to delivery, a consultation can be scheduled prior to birth
     
  • Synchronous resuscitation support at the bedside creates educational opportunities for hospital staff to learn from neonatologists

The costs to implement the neonatal telehealth service were limited, Minton said. "No additional FTE were added for the newborn critical care program, only the dedicated efforts of physician champions. The service was implemented with technology and implementation support from telehealth team."

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


KEY TAKEAWAYS

Ten percent of newborns require breathing assistance and 1% need resuscitation.

Intermountain Healthcare's neonatal telehealth service enables participating community hospitals to avoid transferring some critically ill newborns.

Averting transfers cuts costs and avoids clinical risks such as handoff communication errors.


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