ExpectationsOutcomes of Developing Robotic Program in Academic Neonatal Medicine

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Expectations/Outcomes of Developing Robotic
Program in Academic Neonatal Medicine
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2008 ... As The Year Of The ROBOT
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ROBOTS HAVE LANDED IN KENTUCKY!
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Rural Kentucky and Tertiary Healthcare
Important level I II (yellow) and level II
III (red) referral nurseries to the University of
Louisville Neonatal Medicine Closest other
tertiary hospitals ( blue)
Evansville
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LOUISVILLE
St. Marys
Nashville - Vanderbilt
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KOSAIR CHILDRENS HOSPITAL

• 253-BED TEACHING FACILITY
• PRIMARY TEACHING HOSPITAL FOR THE UNIVERSITY OF
  LOUISVILLE HEALTH SCIENCES PROGRAM
• APPROXIMATELY 8,000 ADMISSIONS PER YEAR
• 97 BED NICU

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KOSAIR CHILDRENS HOSPITAL TRANSPORTS

• 97 Bed Neonatal Intensive Care Unit (NICU)
• 1,158 Total Admissions To NICU (Level II III)
  in 2007
• 658 Neonatal Medicine Transports in 2007
• Estimated Average Cost Per Transport
• Air Transport 8,800
• Ground 2,200

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Goal Improve Healthcare For Newborns In Rural
Kentucky Using A Robotic System
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Expectations And Role

• For Robotics In Neonatal Medicine

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Roles for the Robotic System in Neonatal Medicine

• Neonatal Consultation
• Stabilization
• Education
• Access To Other Consultants
• Improved Communication With Families

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Neonatal Consultation

• Provide referral physicians in rural Kentucky
  hospitals 24 hour/7 day per week visual
  consultation for newborn infants
• Provide a better means to determine if and when a
  patient needs to be transferred
• Improve patient care by allowing those patients
  that really do not need to be transferred to
  remain at the home hospital while allow more
  expedited transfer of patients that need
  intensive care

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Stabilization

• The robotic system allows for a neonatologist to
  be at the bedside to assist the referral
  physician and nursing staff with stabilization of
  the critically ill infant until arrival of the
  transport team
• The robotic system allows for the neonatologist
  to remotely monitor the infant closely until
  arrival of the transport team
• The robotic system assists the neonatologist and
  transport team in patient management issues
  before leaving the referral hospital

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Education

• The robotic system can be used as means
• to help staff at the referral hospitals
• with
• The instruction of various emergent and
  non-emergent procedures (i.e. chest tube, PICC,
  surfactant administration)
• Use of equipment (i.e. ventilators, NCPAP)
• Interpretation of studies (i.e. x-rays)

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Access To Other Consultants

• Besides neonatology, the robotic system will
  allow other subspecialties the ability to consult
  (i.e. genetics, cardiology, infectious disease)
• Plans are to expand the robotic service to the
  pediatric intensive care unit and the pediatric
  emergency room department

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Communication With Families

• The robotic system will allow direct
  communication with parents during the
  consultation
• The robotic system allows the parents to meet the
  physician face-to-face that will be taking care
  of their child in the event the infant is
  transferred

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Outcome

• GOALS

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Outcome Goal 1

• Improve patient care by allowing those who do
  not need to be transferred to remain at the home
  hospital

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Disadvantage Of Patient Transport

• Cost And Safety Risks

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Outcome Goal 2

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Robotic System Enhance Stabilization
Expedite Decision To Transfer Improve
Patient Care And Outcome
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PROBLEMS

• Establishing Program

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Issues To Overcome

• Insure And Maintain Exceptional Technical Support
• Convince Medical Staff At Referral Hospitals The
  Benefits Of The Robotic System
• Simplify Process To Use Robotic System For Both
  Consultants And The Referral Medical Staff
• Dispel Concept Of Second Class Citizen
  Especially In Rural Areas

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Issues To Overcome

• Credentialing At Referral Hospitals
• Establishment Of Protocols For Robotic Use At
  Referral Hospitals
• Legal Issues And Concerns

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