Am J Perinatol 2019; 36(04): 393-398
DOI: 10.1055/s-0038-1668558
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Telemonitoring of Neonatal Intensive Care Units: Preliminary Experience in the State of Minas Gerais, Brazil

Maria do Carmo B. Melo
1   Medical School of the Federal University of Minas Gerais, Minas Gerais, Brazil
,
Alaneir F. Santos
1   Medical School of the Federal University of Minas Gerais, Minas Gerais, Brazil
,
Humberto J. Alves
1   Medical School of the Federal University of Minas Gerais, Minas Gerais, Brazil
,
Thaís C. N. Queiroz
2   Clinical Hospital, Federal University of Minas Gerais, Minas Gerais, Brazil
,
Nara L. C. Silva
3   Minas Gerais State Department of Health, Minas Gerais, Brazil
› Author Affiliations
Further Information

Publication History

10 September 2017

07 July 2018

Publication Date:
21 August 2018 (online)

Abstract

Objective This article describes the implementation and functioning of a telemonitoring center of neonatal intensive care units (NICUs) organized by the Telehealth Center of the Medical School of the Federal University of Minas Gerais who signed an agreement with the Minas Gerais State Department of Health (SES/MG, in Portuguese), Brazil.

Study Design This is a descriptive retrospective study from December 2012 to June 2014 of a NICU telemonitoring project.

Results Twelve Web conferences have been performed. Six thousand, eight hundred and thirty nine (6,839) online teleconsultations of pediatricians and nurses with experience in neonatology and intensive care have been performed, of which 174 were with subspecialists, with an average response time of 6 hours.

Discussion The project has demonstrated to be satisfactory, with fast response in relation to the demands of subspecialists, promoting care, and management support to the NICU. The qualification via Web conferences prevents the displacement of the professionals to big centers for continuous medical education.

Conclusion The telemonitoring of NICU can contribute in the process of management, regulation of beds, reduction of displacements and transferences, adhesion to best practices, care support, and qualification of the involved professionals.

 
  • References

  • 1 World Health Organization. Telemedicine - Opportunities and developments in Member States. Report on the second global survey on eHealth Global Observatory for eHealth series. Available at: http://www.who.int/goe/en/ . Accessed February 5, 2017
  • 2 DATASUS. Child mortality rate in Minas Gerais, Brazil. Available at: http://tabnet.datasus.gov.br/cgi/deftohtm.exe?sim/cnv/inf10mg.def . Accessed March 3, 2017
  • 3 International Classification of Diseases. CID 10. Available at: http://www.datasus.gov.br/cid10/V2008/cid10.htm . Accessed February 3, 2017
  • 4 França BF, Lansky S, Rego MAS. , et al. Leading causes of child mortality in Brazil, in 1990 and 2015: estimates from the Global Burden of Disease study. Rev Bras Epidemiol 2017; 20 (Suppl 01): 46-60
  • 5 Donabedian A. The quality of medical care. Science 1978; 200 (4344): 856-864
  • 6 Rosenfeld BA, Dorman T, Breslow MJ. , et al. Intensive care unit telemedicine: alternate paradigm for providing continuous intensivist care. Crit Care Med 2000; 28 (12) 3925-3931
  • 7 Breslow MJ, Rosenfeld BA, Doerfler M. , et al. Effect of a multiple-site intensive care unit telemedicine program on clinical and economic outcomes: an alternative paradigm for intensivist staffing. Crit Care Med 2004; 32 (01) 31-38
  • 8 Thomas EJ, Lucke JF, Wueste L, Weavind L, Patel B. Association of telemedicine for remote monitoring of intensive care patients with mortality, complications, and length of stay. JAMA 2009; 302 (24) 2671-2678
  • 9 Franzini L, Sail KR, Thomas EJ, Wueste L. Costs and cost-effectiveness of a telemedicine intensive care unit program in 6 intensive care units in a large health care system. J Crit Care 2011; 26 (03) 329.e1-329.e6
  • 10 Morrison JL, Cai Q, Davis N. , et al. Clinical and economic outcomes of the electronic intensive care unit: results from two community hospitals. Crit Care Med 2010; 38 (01) 2-8
  • 11 Lilly CM, Cody S, Zhao H. , et al; University of Massachusetts Memorial Critical Care Operations Group. Hospital mortality, length of stay, and preventable complications among critically ill patients before and after tele-ICU reengineering of critical care processes. JAMA 2011; 305 (21) 2175-2183
  • 12 Young LB, Chan PS, Lu X, Nallamothu BK, Sasson C, Cram PM. Impact of telemedicine intensive care unit coverage on patient outcomes: a systematic review and meta-analysis. Arch Intern Med 2011; 171 (06) 498-506
  • 13 Wilcox ME, Adhikari NK. The effect of telemedicine in critically ill patients: systematic review and meta-analysis. Crit Care 2012; 16 (04) R127
  • 14 Nesbitt TS, Dharmar M, Katz-Bell J, Hartvigsen G, Marcin JP. Telehealth at UC Davis--a 20-year experience. Telemed J E Health 2013; 19 (05) 357-362
  • 15 McCambridge M, Jones K, Paxton H, Baker K, Sussman EJ, Etchason J. Association of health information technology and teleintensivist coverage with decreased mortality and ventilator use in critically ill patients. Arch Intern Med 2010; 170 (07) 648-653
  • 16 Health State Secretary of Minas Gerais, Brazil Project Mothers of Minas. Available at: http://maesdeminas.saude.mg.gov.br/sobre-o-projeto-maes-de-minas/ . Accessed March 2, 2016
  • 17 Pronovost PJ, Angus DC, Dorman T, Robinson KA, Dremsizov TT, Young TL. Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review. JAMA 2002; 288 (17) 2151-2162
  • 18 Pollack MM, Cuerdon TT, Patel KM, Ruttimann UE, Getson PR, Levetown M. Impact of quality-of-care factors on pediatric intensive care unit mortality. JAMA 1994; 272 (12) 941-946
  • 19 Goh AY, Lum LC, Abdel-Latif ME. Impact of 24 hour critical care physician staffing on case-mix adjusted mortality in paediatric intensive care. Lancet 2001; 357 (9254): 445-446
  • 20 Norris AC. Essentials of Telemedicine and Telecare. Baffins Lane, England: John Wiley & Sounds; 2002: 177
  • 21 Otero AV, Lopez-Magallon AJ, Jaimes D. , et al. International telemedicine in pediatric cardiac critical care: a multicenter experience. Telemed J E Health 2014; 20 (07) 619-625
  • 22 Medicine Federal Council/Medicine Regional Council of São Paulo. Scenes and pointers of distribution. Medical demography in Brazil. Vol. 2; 2013. Available at: http://www.cremesp.org.br/pdfs/DemografiaMedicaBrasilVol2.pdf . Accessed March 3, 2014
  • 23 Labarbera JM, Ellenby MS, Bouressa P, Burrell J, Flori HR, Marcin JP. The impact of telemedicine intensivist support and a pediatric hospitalist program on a community hospital. Telemed J E Health 2013; 19 (10) 760-766
  • 24 Haskins PA, Ellis DG, Mayrose J. Predicted utilization of emergency medical services telemedicine in decreasing ambulance transports. Prehosp Emerg Care 2002; 6 (04) 445-448
  • 25 Tsai SH, Kraus J, Wu HR. , et al. The effectiveness of video-telemedicine for screening of patients requesting emergency air medical transport (EAMT). J Trauma 2007; 62 (02) 504-511
  • 26 Dharmar M, Romano PS, Kuppermann N. , et al. Impact of critical care telemedicine consultations on children in rural emergency departments. Crit Care Med 2013; 41 (10) 2388-2395
  • 27 Dharmar M, Kuppermann N, Romano PS. , et al. Telemedicine consultations and medication errors in rural emergency departments. Pediatrics 2013; 132 (06) 1090-1097
  • 28 Smith AC, Armfield NR. A systematic review and meta-analysis of ICU telemedicine reinforces the need for further controlled investigations to assess the impact of telemedicine on patient outcomes. Evid Based Nurs 2011; 14 (04) 102-103
  • 29 Kohl BA, Fortino-Mullen M, Praestgaard A, Hanson CW, Dimartino J, Ochroch EA. The effect of ICU telemedicine on mortality and length of stay. J Telemed Telecare 2012; 18 (05) 282-286
  • 30 Marcin JP. Telemedicine in the pediatric intensive care unit. Pediatr Clin North Am 2013; 60 (03) 581-592