NH Hospital Uses Telehealth to Support Difficult Deliveries

A telemedicine network launched by Massachusetts General Hospital to provide on-demand neonatal support has expanded into New Hampshire.

Dover-based Wentworth-Douglass Hospital is now connected with specialists at the Boston hospital for virtual care assistance on difficult and dangerous births. The TeleNewborn Consult Program is expected to help Wentworth-Douglass’ Women and Children’s Center, which sees more than 1,300 deliveries a year, keep more patients in-house and improve outcomes.

The program “is a wonderful opportunity to care for premature newborns at Wentworth-Douglass Hospital that would normally be transferred to a different level of care,” Sheila Woolley, RN, BSN, MPH, the hospital’s chief nursing officer, said in a press release. “We’ll be able to keep those babies with their families in their community, which is so important for everybody. As you can imagine, it’s extremely difficult and incredibly emotional being separated from your brand-new baby. This program will allow us to maintain family centered care, which is so important."

The partnership highlights the growing popularity of telehealth for ICU care, particularly in neonatal intensive care units, which only number about 750 in the US. In a hub-and-spoke telemedicine network, larger hospitals with neonatal ICUs, like MGH, connect with smaller and rural hospitals to offer 24/7 support and off-hours coverage.

Such programs help those smaller hospitals care for and keep more patients instead of transporting them to a larger facility – a costly and complicated process that exposes both infant and parents to extra stress. The platform also allows NICU specialists to intervene more quickly on a difficult case, improving health outcomes and helping to stabilize patients when a transport is necessary.

Roughly four years ago, researchers at the Mayo Clinic found that access to NICU specialists could help rural and remote hospitals reduce transports by one-third, improving care and outcomes for those patients (and their families) and helping those hospitals to keep more of their patients.

“The enhanced access to neonatologists, who could remotely assess the newborn and guide the local care team through the resuscitation, allowed one-third of the babies to stay with their families in the local hospital,” Jennifer Fang, MD, a Mayo Clinic fellow in neonatal-perinatal medicine, said in a 2016 press release issued by the hospital. “This allowed the patients to receive the correct level of care in the right location - increasing the value of care. Also, the potential cost savings can be substantial.”

Among the front-runners in the tele-NICU movement is Salt Lake City-based Intermountain Healthcare, which launched its virtual care platform in 2012. The hospital’s program, which connects almost two dozen Rocky Mountain hospitals to four NICUs in a hub-and-spoke network, was profiled last year in a study published in the journal Health Affairs.

“We’re raising the level at all of the hospitals,” Stephen Minton, MD, the medical director of neonatology at Intermountain's Utah Valley Hospital in Provo, told mHealthIntelligence in a January 2019 interview. “And that level of care … is significantly better than it was before.”