Effect of telemedicine on health outcomes in 87 infants requiring neonatalintensive care

Objective: This is an evaluation of a telemedicine system for the rapid int erpretation of neonatal echocardiograms from a regional, level III neonatal intensive care unit (NICU). The use of telemedicine to support the cardiol ogy needs of NICUs is increasing. However, there is very little published o bjective information regarding health outcomes or costs resulting from such telemedicine systems. The primary hypothesis tested was that the utilizati on of a telemedicine system for the interpretation of neonatal echocardiogr ams reduces the intensive care length of stay of low birthweight (LBW) infa nts. Study design: All infants who were admitted to neonatal intensive care at N ew Hanover Regional Medical Center during the first six months of the syste m were studied by the use of echocardiograms. They were compared with infan ts who were born in the same period of the previous year. The outcome measu res were the intensive care length of stay, rate of transfer to academic me dical centers, and mortality rate. Results: A statistically non-significant reduction of 5.4 days in the inten sive care length of stay (LOS) of low birthweight infants was observed (p = 0.37). The cost per echocardiogram transmitted was calculated at $33 compa red to previous method of sending videotapes via overnight courier. Conclusions: While the sample size was inadequate to demonstrate improvemen ts in health outcomes, the magnitude of the change and the low costs of the system suggest that this intervention is practical for obtaining rapid dia gnostic and treatment support. Larger studies are warranted to confirm thes e findings and determine whether faster diagnosis and earlier initiation of treatment improve health outcomes of newborn infants.