P3.263: Can Telehealth Improve Care in Neonatal Transport?

Purpose/Objectives: Emergency transport of neonates presents significant challenges in Hawaii given our unique geography. Coordination of ground and air transport required to move patients to specialty care is further complicated by the lack of a common electronic medical record (EMR) and telehealth platform for all birthing hospitals. Epic® Video Chat (EVC) has increased access to healthcare across multiple specialties in the state; however, it has not been utilized during neonatal transport (NT). Implementing EVC during NT could improve decision making for physicians and provide real-time updates for parents.

Aim Statement: We aim to increase EVC use in our NICU during NT by 50% in two years by providing education and necessary resources to optimize workflow and improve the quality of communication.

Design/Methods: To start, we chose to use EVC to update parents of transported neonates who often remain at the referring hospital. Project introduction and EVC training began in December 2024. Neonatology staff were encouraged to use EVC to update parents following admission of a transported newborn and asked to document their telehealth call using a dedicated note template. EMR review of transported patients was performed every two weeks and post-EVC surveys assessing call quality and satisfaction were sent to the parents and providers who participated on the call. Several plan-do-study-act-cycles were conducted to identify causes and address low rates of EVC use. One-on-one education revealed additional barriers to EVC use related to personal cell phone use and availability of hospital devices to conduct EVC calls (Figure 1).

Results: Baseline usage of EVC was 0% prior to December 2024. In the month following introduction of the project and initial training at a division meeting, EVC was only used once for 20 NT patients. Following individualized training of neonatology staff, we saw a steady increase in the use of EVC for NTs (Figure 2).
Response rate to the post-EVC survey from both parents and providers was 50% (n=8). Parents reported that they enjoyed being updated via EVC and found it easy to connect. Providers also reported no problems with set up or connection. Parents and providers rated video quality as high or very high 75% of the time, while sound quality was rated as low 37% of the time.

Conclusion/Discussion: EVC following NT to update parents has received positive feedback from both parents and providers. However, we identified several barriers to implementation. Future interventions are aimed at providing resources to providers who do not have the EMR application on their phone. Early adopters of EVC for NT have already begun using telehealth for transport intake calls, the next planned phase of our project. Direct provider-to-provider communication and visualization of the neonate may improve communication, satisfaction, and patient care.