Using Teleneonatology to Improve the Patient Experience

In the neonatal intensive care unit (NICU), we try to ignore averages. As a leading national medical group, it’s our duty to do everything we can for every newborn—whether they were born at full-term, at 24 weeks, or anywhere in between.

The stark reality is, however, the average stay in the NICU is excruciatingly long. The tiniest infants could be in the NICU for 100 days or more. As gut-wrenching as it can be to witness, it is equally painful to watch parents be separated from their infants. Parents with jobs and other children simply cannot be in the NICU every moment of the day—and during health emergencies such as the COVID-19 pandemic, they are unable to be there at all.

Virtual health and Teleneonatology programs can help hospitals keep parents connected to their babies and the clinicians who are caring for them. While there is no substitute for being at the bedside, digital tools can improve the patient experience by reducing parent stress and offering access to expertise across specialties. Virtual health programs also can help babies and their parents thrive after leaving the hospital and decreasing their likelihood of being readmitted to the NICU.

Together, these elements put even the smallest of infants and their families on the path toward a healthy life.

Teleneonatology Programs Reduce Parent Stress

Ask a parent to recall the first time they left their baby in someone else’s care and, chances are, they will remember the event vividly. Even if the caregiver was a grandparent, leaving your child for the first time is a stressful—if not tearful—experience.

Now imagine leaving an infant who has not yet reached gestational age. The separation can be traumatic, particularly for a mother who is recovering from childbirth.

The experience of being separated from a baby in the NICU became more common during the COVID-19 pandemic. According to a study published in August 2020 in the Journal of Perinatology, 85 percent of NICUs restricted parental presence to only one parent at a time due to COVID-19. One-quarter of hospitals required families to choose a single parent to be allowed into the NICU for the entire hospital stay.

Many hospitals turned to Teleneonatology programs to ease this separation. Why? Because virtual health programs have been proven to reduce parent stress.

In 2018, a team from Children’s Hospital in Philadelphia administered the Parent Stress Scale NICU version (PSS-NICU) to parents with babies in their NICU. The researchers found that parents who were able to use a simple bedside camera to just watch their infant “reported lower levels of stress related to the sights and sounds of the unit, the appearance of the baby, and their relationship with the infant and parental role.”

These parents’ experiences were more positive than those of the parents who did not access the video. In fact, “parents who used the camera reported significantly less stress related to being separated from their babies than those who did not use the camera, with 22 percent of parents who used the bedside camera reporting that separation from their baby was very or extremely stressful in comparison to 63 percent of parents who did not use the camera.”

Using two-way audio and visual technology, virtual health programs allow parents to participate in daily and nightly rounds at the hospital, giving them the opportunity to interact and ask questions to their baby’s caregivers at the press of a button.

This technology can also be used to enhance the care provided at the hospital and to ensure quality care after discharge in a way that will reduce NICU readmissions.

Teleneonatology Programs Address Specialty Gaps in Underserved Communities

According to a 2016 analysis by researchers at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, infants born at 24 weeks in the United States had a 68 percent chance of survival. This statistic inspires a lot of hope—those odds of survival would have been unfathomable just a few decades ago.

Parents and babies have more hope than ever, but neonatologist shortages, particularly in rural communities and critical access hospitals, threaten this progress and, with it, families’ dreams of a bright future for their smallest bundles.

Incorporating virtual health technology into a health system gives parents and clinicians access to a reservoir of expertise that they otherwise would not have had.

While one in 10 U.S. births are premature—a rate that is higher than in other developed countries—it is likely that most emergency physicians and obstetricians have never delivered a baby at 24 weeks (or even 28 weeks). Having a board-certified neonatologist on virtual standby can provide on-site clinicians with valuable insight about how to react in an intense, unfamiliar and critical situation.

That access could save a life, but the results need not be so dramatic to make the investment in a Teleneonatology program worth it. Parents’ knowledge that their community hospital has access to expert neonatologists across the country – or even across the globe – will further reduce parent stress levels, increase their confidence in their local health system and reduce the number of NICU readmissions.

Virtual Health Helps Prevent NICU Readmissions

Parents are flooded with happiness when they leave the hospital, but we also flood them with information. In the first few hours at home, and the days and weeks after, it can be difficult to remember essential care instructions.

According to a study of premature infants in California published in the Journal of Perinatology in August 2007, approximately 15 percent of preterm infants required at least one hospital readmission within the first year of life. The average cost per readmission was nearly $8,500. Nearly one-third of infants born at 25 weeks or less were readmitted. The average length of stay of 12 days.

By using digital tools that connect parents, pediatricians, family medicine practitioners and board-certified neonatologists, we can create a post-discharge support structure that will reduce the infants’ chance of readmission. 

Teleneonatology for a Healthy Life

Ultimately, a family’s experience in the NICU doesn’t have to be shaped only by the number of days their baby spent in the hospital. Whether it was one day or 100, if an infant leaves healthy, strong and supported, the struggle was worth it.

Implementing virtual health programs into hospital NICUs make the goal of a long, healthy life easier to attain, providing parents with the ultimate peace of mind.