The effect of a newborn telehealth program on transfers avoided

Abstract

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.