Beam me in, Scotty: Telemedicine in Education, Clinical Medicine and Research

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Center for Translational Neuroscience
Seminar Series
Tuesday, October 14, 2008, 12 noon Rayford
Auditorium, Biomed II Bldg.
Beam me in, Scotty Telemedicine in Education,
Clinical Medicine and Research Richard Whit
Hall, M.D. Department of Pediatrics, Section of
Neonatology, UAMS
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Introduction. Practicing clinicians, especially
in rural areas, are often isolated from learning
opportunities and interaction with subspecialty
providers. Telemedicine can enhance communication
to provide education, improve clinical outcomes
and expand research into the community. A
Pediatric Physician Learning and Collaborative
Education (Peds PLACE) program was developed to
address education telenursery was established to
improve clinical outcomes through guidelines and
regionalization and research was undertaken to
evaluate this program. Methods. Peds PLACE was
assessed using two evaluation forms collected
from October 2007 to May 2008. One of them was
completed by 221 attendees from the University of
Arkansas for Medical Sciences (UAMS) and 193 from
remote sites. Another form was completed by 131
participants from Arkansas Childrens Hospital
(ACH), an academic free standing childrens
hospital. All used Likert evaluation scales.
Clinical outcomes were compared using mortality
and intraventricular hemorrhage rates of very low
birthweight babies and place of delivery using a
linked Medicaid database before and after
institution of telecommunication with outlying
intensive care nurseries. Funding, publication
and dissemination of translational research to
the community were assessed. Results.
Education. Ninety-five per cent of Peds PLACE
participants agreed that the presentations
related to their professional needs, 98 agreed
that it increased their subject matter knowledge,
81 evaluated the presentations as some of the
best they have attended, and 93 agreed that the
information would translate into professional
practice, enhancing patient care. Comments were
generally positive and correlated with Likert
scale data. Clinical. Regionalization was
improved after telenursery was established which
resulted in improved clinical outcomes. Of
neonates lt1000 grams, 24 were transferred to
UAMS for delivery before telenursery while 33
were transferred after telemedicine (plt0.001)
the delivery place of larger neonates was
unaffected (p ns). Survival of all VLBW neonates
delivered at UAMS was 91, while survival of VLBW
neonates delivered elsewhere was 85 (plt0.01).
Early neonatal mortality decreased after
telemedicine was instituted from 1.73 to 1.46
at UAMS and from 0.63 to 0.35 in small NICUs.
Research. There have been 10 abstracts, 3
publications, and almost 3,000,000 in federal
funding related to telemedicine projects. The
translational research portion of Peds PLACE
resulted in 95 of clinicians finding it relevant
to their practice. Conclusions. Participants
reported being highly satisfied with Peds PLACE
and considered it an effective way to address the
continuing education needs of practitioners.
Clinical outcomes of VLBW neonates have improved
after telecommunication, likely as a result of
regionalization. Research has been enhanced by
telemedicine as evidenced by publications and
funding. Supported by USPHS Grant RR20146, AR
Medicaid and ANGELS