Telehealth Helped Improve Attendance Rates at NICU Follow-Ups

While analyzing the effects of telehealth use on neonatal intensive care unit (NICU) follow-ups, a study conducted by Maine Health and published in Hospital Pediatrics found that telemedicine consultation led to improved attendance rates within NICU follow-up clinics among infant patients.

According to the Centers for Disease Control and Prevention (CDC), preterm birth is a baby born before 37 weeks of pregnancy. The CDC also noted that the preterm birth rate rose between 2020 and 2021, affecting about 10.1 percent and 10.5 percent of pregnancies each year, respectively.

NICU follow-ups are critical in caring for this high-risk population because they can help clinicians identify abnormalities in neurodevelopmental status. And, due to the risks related to lower cognitive, motor, and academic performance, those infants who are discharged from the NICUs need ongoing monitoring in follow-up clinics. In this study, researchers added a telehealth visit prior to discharge, hypothesizing that programmatic changes could lead to improved follow-up clinic attendance rates.

Researchers included infants who survived premature birth, defined as 29 weeks or less. They also included infants who suffered from brain injuries such as intraventricular hemorrhage, stroke, seizure, or hypoxic-ischemic encephalopathy.

Study measurements included a comparison of follow-ups among the early cohort, that is, NICU patients from January 2018 to June 2019 without access to telehealth before discharge, and the late cohort, which included NICU patients between May 2020 and May 2021 who had access to telehealth before discharge. Researchers also performed a mediation analysis to review other programmatic changes for the late cohort, such as improved documentation to parents and primary care providers about the NICU follow-up.

Following a review of the data, researchers found that the rate of successful 12-month follow-ups rose from 26 percent in the early cohort to 61 percent in the late cohort. They also found that the chances of attending a 12-month follow-up visit were 3.7 times higher for infants in the late cohort. 

Further, researchers found that the improved documentation to parents, but not to primary care providers, increased the likelihood of a successful follow-up.

“Telemedicine consultation before NICU discharge, in addition to improving communication regarding the timing and importance of NICU follow-up, was effective at improving the rate of attendance to NICU follow-up clinic,” said study author Alexa K. Craig, MD, a neonatal and pediatric neurology physician at MaineHealth and assistant professor of pediatrics at Tufts University School of Medicine, in an email.

The use of telehealth in maternal care has become increasingly common as clinicians have found it provides benefits for various individuals.

In October, Avera Health announced that it aimed to improve maternal care outcomes alongside enhancing rural healthcare access through telehealth and remote patient monitoring after receiving funding from the federal Health Resources and Services Administration.

Specifically, Avera said it planned to target the health services provided to rural and maternal populations through virtual care services, thereby increasing access to obstetrics services and improving outcomes related to pre-term labor, low birth weight, and infant mortality.