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EP-103 - Impact of Pediatric Emergency Assistance for Newborn Using Telehealth on Neonatal Transfers from Rural Hospitals

Monday, April 30
9:35 AM - 9:50 AM
Location: Education Zone, Booth 2416, Screen 1

Aim: To develop a telehealth program to serve labor and delivery units in rural hospital nurseries in Northern California with timely evaluations and interventions from neonatologists and other pediatric subspecialists to improve health outcomes among infants delivered in underserved areas.
Methods: The Pediatric Emergency Assistance to Newborns Using Telehealth (PEANUT) is a comprehensive telehealth program that provides continuous access to neonatologists and other pediatric subspecialists to a network of six rural hospital nurseries. PEANUT supports care for newborns in rural hospitals by providing access to neonatologists and other pediatric specialists through telemedicine and phone consults These consults may include diagnostic and clinical support as well as interpretation of screening tests that may indicate a transfer, including pulse oximetry and echocardiograms. The program also seeks to improve the ability of rural providers to better treat newborns in their own communities by providing live monthly training and ongoing education to rural providers, including physicians, nurses, and technicians. Consultations may occur through telephone or telemedicine.
Results: Since the launch of the program in August 2015, PEANUT has provided specialist consultations to a total of 302 newborns at six rural hospitals in Northern California. 68 of these consultations were telemedicine consultation and 234 were telephone consultations. PEANUT also provided pediatric cardiology consultations for echocardiogram for 211 newborns who either failed pulse oximetry screening for critical congenital heart defects or were suspected to have a congenital heart defect. Of the 302 newborns who received a telemedicine or phone consultation, 227 (75.2%) were transferred to a tertiary care facility. Transfer rates varied by site, ranging from 53.1% to 88.3%. Telemedicine consults were less likely to result in a transfer than phone consults (63.2% vs 78.6%, p=0.010).

Conclusion: PEANUT may be effective in reducing unnecessary transfers to tertiary facilities. PEANUT provides timely access to pediatric subspecialists for care in the patient's own community; it also provides education and training to healthcare providers in the rural hospital which increase the level or competency of care that can be provided locally. PEANUT demonstrates a new model of care that can be adopted as a clinical service line for other children's hospitals in a competitive healthcare market.

Learning Objectives:

Madan Dharmar

Associate Professor in Residence
Univeristy of California Davis Health System

Madan Dharmar is an Associate Professor in Residence at the Department of Pediatrics at the UC Davis School of Medicine and Betty Irene School of Nursing at UC Davis. He directs the CTSC Digital and Connected Health Initiative at UC Davis. A physician, clinical epidemiologist and federally funded researcher, Dharmar’s area of interest is health services research and mobile-health technology, or mHealth. His research focus is in the development of innovative care models for the improving care across the lifespan. He is the principal investigator and director for the federally funded, Pediatric Emergency Assistance for Newborns Using Telehealth (PEANUT) Program. He is also an integral part of an interprofessional research team at UC Davis. He earned his medical degree from Madras Medical College in Chennai, India in 1995, where he also completed an internship and fellowship. He earned a Doctor of Philosophy degree in Epidemiology from UC Davis. He has written several book chapters and has been published in several peer-reviewed journals including Pediatrics, Critical Care Medicine, Journal of Pediatrics, Telemedicine and e-Health, and Annals of Emergency Medicine.

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