American College of Physicians: Internal Medicine — Doctors for Adults ®


Telemedicine in the NICU

From the June 2000 ACP-ASIM Observer, copyright 2000 by the American College of Physicians-American Society of Internal Medicine.

By Ingrid Palmer

PHILADELPHIA—In a somewhat unusual use of telemedicine technology, a Boston hospital electronically linked sick babies with their parents and siblings at home.

As part of a government-funded study called Baby CareLink, Beth Israel Deaconess Medical Center in Boston installed two-way video conferencing systems in a neonatal intensive care unit and in the homes of 26 families who had high-risk, low birth-weight babies. The program enabled families who were going to be separated from their infants for an extended period of time to check up on their babies and communicate with hospital staff from home.

Charles Safran, FACP, clinical associate professor of medicine at Harvard Medical School, described the program during an Annual Session presentation, "Introduction to Telemedicine and Home Health Care." The study began in December 1997 and is scheduled to be complete in September.

Hospital staff scheduled time throughout the day when the parents could watch their babies through the video system. Families could also communicate with the baby and nurses through an audio setup that uses telephone lines.

The hospital also created a Web site for parents with links to medical libraries, a baby photo gallery, a daily report on each baby's health and a list of e-mail addresses for medical staff. Families could access information such as the baby's heart rate and weight gain through daily updates on the site.

"Every baby had her picture taken every day," Dr. Safran said, adding that parents could post the photos on the Web for friends and family to view. One father who went through the process said, "It's not as good as holding your baby in your arms, but those pictures sure add a lot."

The Web site also gave parents information about post-discharge care, which Dr. Safran said changed "the relationship between how we hand off care from acute care settings to the home environment."

Because parents were involved more intimately in the baby's recovery, Dr. Safran said, they were more comfortable taking on some of the care responsibilities and were able to bring babies home sooner. They remained connected to the hospital via video for three months after the baby was discharged, so when questions arose about their infant's health, they could set up a video conference with doctors for advice.

Besides giving parents more resources and education, the Baby CareLink program lowered hospital costs. Dr. Safran said that for babies weighing less than 1,000 grams, hospitalization was reduced by 16 days, producing an estimated savings of $2,500 per day. On average, the program reduced hospitalization by two days per infant.

Dr. Safran noted that doctors in other subspecialties are also experimenting with and benefiting from telemedicine technologies, such as pacemaker surveillance and EKG event recorders.


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