Caring for a premature baby can be trying enough, let alone when the parents live far from the hospital and have to transport the fragile infant many miles for care, disrupting the family and increasing the risk of harm.
With that in mind, two Texas hospitals are working to revolutionize neonatal care with an assist from telemedicine. Using the same tools that help doctors to treat workers on offshore oil rigs, University of Texas Southwestern physicians working at Children's Medical Center in Dallas can assess and diagnose ill babies more than 100 miles away at Trinity Mother Frances Hospital in Tyler. A mobile equipment cart allows docs in Dallas to view babies and give them the ability to listen remotely to a baby's heart and belly and examine his or her ears and mouth.
"The world is shrinking and it's important for any baby to have a viable, safe and immediate connection to the level of expertise he or she requires, anywhere, so that you can actually call and have that expertise right at hand," says Rashmin Savani, M.D., division director of neonatal-perinatal medicine at UT Souothwestern and Children's. "Having it available through telemedicine is going to enhance the ability and the level of care everywhere."
Children's had already been collaborating with Trinity Mother Frances for a number of years and decided to try telemedicine more recently. The five-hospital, faith-based nonprofit has a Level 3 neonatal intensive care unit in Tyler, but at times it had to tap into Children's Level 4 NICU for added expertise to treat the most seriously ill babies. Savani estimates that 10 to 12 percent of all infants end up in a NICU, and 1 to 2 percent need the highest level of care. The rarity of those cases, coupled with the high cost of having such expertise on staff, make it hard for all hospitals to run a Level 4 NICU.
In the past, Children's experts had to rely on emailed pictures and examinations performed by other doctors. At times, without complete information, doctors would send newborns from Tyler to Dallas, and later learn that the trip was unnecessary, risking potential harm to the baby, Savani says. Now, with the new Tele-NICU, physicians can do a much better job of screening patients to make sure they absolutely must be transported to Dallas.
There are other benefits to the program. Now, instead of shipping doctors around the country to give lectures, UT Southwestern and Children's Medical Center can educate clinicians nationwide through the telemedicine portal. Plus, it's highly beneficial to families to see doctors at both hospitals working together.
"The family can see there's a collaboration going on between their physician and us, and that we're carefully thinking about their baby," Savani says.
The two organizations first rolled out their new service in early September, and it's already treated a dozen or so newborns. Children's is working to track data to demonstrate its success, but Savani says, anecdotally, the results have been positive thus far. He'd love to see outposts set up all over the country, and advanced talks establishing similar collaborations with other hospitals are occurring.
"That's the beauty of the Internet. You can put an outpost anywhere," Savani says.