Telemedicine collaboration improves perinatal regionalization and lowers statewide infant mortality

OBJECTIVE: We assessed a telemedicine (TM) network's effects on decreasing deliveries of very low birth weight (VLBW, < 1500 g) neonates in hospitals without Neonatal Intensive Care Units (NICUs) and statewide infant mortality. STUDY DESIGN: This prospective study used obstetrical and neonatal interventions through TM consults, education and census rounds with 9 hospitals from 1 July 2009 to 31 March 2010. Using a generalized linear model, Medicaid data compared VLBW birth sites, mortality and morbidity before and after TM use. Arkansas Health Department data and chi(2) analysis were used to compare infant mortality. RESULT: Deliveries of VLBW neonates in targeted hospitals decreased from 13.1 to 7.0% (P = 0.0099); deliveries of VLBW neonates in remaining hospitals were unchanged. Mortality decreased in targeted hospitals (13.0% before TM and 6.7% after TM). Statewide infant mortality decreased from 8.5 to 7.0 per 1000 deliveries (P = 0.043). CONCLUSION: TM decreased deliveries of VLBW neonates in hospitals without NICUs and was associated with decreased statewide infant mortality.