Statements, opinions and results of studies contained in the program are those of the presenters/authors and do not reflect the policy or position of the Board of Regents of the University of Oklahoma (“OU”) nor does OU provide any warranty as to their accuracy or reliability.

Every reasonable effort has been made to faithfully reproduce the presentations and material as submitted. However, no responsibility is assumed by OU for any claims, injury and/or damage to persons or property from any cause, including negligence or otherwise, or from any use or operation of any methods, products, instruments or ideas contained in the material herein.

Disclaimer

BackgroundComanche Co. Memorial Hospital – Lawton, Ok

3rd largest city outside metropolitan areas

Regional care for 12 county area in Southwest Oklahoma

Approximately 1250 babies delivered annually

~400 babies delivered annually that are preterm or late preterm (32-36 weeks Gestation) in the 12 county area

~7 pediatricians in the area (4 with privileges at CCMH)

Increasing need for on call coverage of nurseries

Need

Growing need for neonatal support

American Academy of Pediatrics revised Guidelines for Neonatal Care

September 2012

CollaborationExisting relationship with CCMH and OUHSC/Children’s Hospital

OU Neonatology Section19 Board eligible or board certified neonatologists

30 Neonatal Nurse Practitioners

OU Telemedicine20+ yrs experience in Telemedicine service delivery

Previous telemedicine relationship with CCMH

Robust technology and telecommunications infrastructure

PlanningIdentify champions and key stakeholders – build a Team

Assess capacity of support staff and services

Evaluate capacity and reliability of technology/telecommunications

Define Operational Processes and ProtocolsCredentialing

Billing

Scope of Practice

Training

Hybrid Model - Team approach6 Neonatologists assigned to team

10 Neonatal Nurse Practitioners/APRNs

Telemedicine cart in CCMH NICU

Telemedicine software on laptops of Neonatologists

Level of SupportNeonatologists

Rotate on site 3 times weekly

No more than 2 days apart

Lawton Neonatologist rounds daily on site

On site total coverage – 236 days

Neonatal Nurse Practitioners

Rotate on site 24 hr shifts

NNP coverage 365 days

Telemedicine supportDial on demand – 24/7/365

Used on days Neonatologists are not on site

Emergent assistance

Technology meets American Telemedicine Association guidelines

HIPPA compliant

High Definition cameras with 40 x zoom

Cameras can be controlled remotely by Neonatologists

Broadband telecommunications connection

Telemedicine examEmbedded video here

Outcomes @ 1 yrOf 400 babies, 290 babies receiving services and/or eliminating transfer to CHOHigh family satisfaction-

reduced travel increased communication Increased understanding and participation in plan of care

Expanded capacity and support for CCMHLaboratory testing and supportPharmacyRadiologyDevelopmental Care/Multidisciplinary Care

Additional training for CCMHNursing staffRespiratory Therapists

Outcomes @ 1 yr cont.$$ Payers saved on avoided transports

$$ families saved not having to go and stay in OKC

$$ families saved with early return from CHO to CCMH of their infant

Advantages Of TelemedicineQuality of Care

Access to care

Reduced transports/reduced transport and travel costs

Increased support services capacity

Increase patient/family satisfaction

Cost Savings previously stated

DisadvantagesPotential increased technical costs

Potential increased need for tech support

Patient/Family Satisfaction -quotes

“The convenience of being here really makes a big difference,” says Daniel Ghrayyeb, Molly’s father

Questions?Dr. Arlen Foulks

Arlen-foulks@ouhsc.edu

405-271-5215

Mike McCoy

Mike-mccoy@ouhsc.edu

405-271-5215