Telemedicine to Improve Use of Therapeutic Hypothermia in Rural Settings
| Status: | Recruiting |
|---|---|
| Conditions: | Hospital, Neurology |
| Therapuetic Areas: | Neurology, Other |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 10/19/2018 |
| Start Date: | April 30, 2018 |
| End Date: | November 1, 2019 |
| Contact: | Alexa Craig, MD |
| Email: | craiga@mmc.org |
| Phone: | 2073967337 |
Leveraging Telemedicine to Reduce Disparities in Time to Initiation of Therapeutic Hypothermia in Rural Settings; a Pilot Feasibility Study
This pilot intervention trial will assess the feasibility of a live consultation between
community hospital providers and tertiary care providers employing a novel teleconsult
platform, Maine Neonatal Encephalopathy Teleconsult (Maine NET), on the time to initiation of
therapeutic hypothermia (TH) for 10 infants born in community hospitals in Maine compared
with matched historical controls. Community hospital providers and tertiary care center
provider satisfaction with the Maine NET platform will also be assessed. We hypothesize that
immediately available expert assessment via a teleconsult platform will promote earlier
implementation of TH and be associated with high levels of provider satisfaction.
community hospital providers and tertiary care providers employing a novel teleconsult
platform, Maine Neonatal Encephalopathy Teleconsult (Maine NET), on the time to initiation of
therapeutic hypothermia (TH) for 10 infants born in community hospitals in Maine compared
with matched historical controls. Community hospital providers and tertiary care center
provider satisfaction with the Maine NET platform will also be assessed. We hypothesize that
immediately available expert assessment via a teleconsult platform will promote earlier
implementation of TH and be associated with high levels of provider satisfaction.
Inclusion Criteria:
Infants included in this study will be born at a community hospital, will be in either high
or moderate risk, will be younger than 6 hours of age at the time of the consultation and
the decision will have been made to treat with TH. High risk infants will be defined as an
umbilical cord pH of less than or equal to 7.0 or 5 minute APGAR score of less than or
equal to 5 or a need for resuscitation (including respiratory support or chest
compressions) or an abnormal exam (which may include flaccid tone, poor suck reflex or poor
response to stimulation) or seizures at less than 6 hours of life. Moderate risk infants
will be defined as an umbilical cord pH of less than or equal to 7.2 but greater than 7.0
or 5 minute APGAR score of less than 7 but greater than 5 or a perinatal event (such as
placental abruption, uterine rupture, cord prolapse, or fetal-maternal hemorrhage) or an
abnormal exam (which may include a hyper-alert state).
Exclusion Criteria:
Infants older than 6 hours at the time Maine NET is requested and infants for whom TH is
not an appropriate therapy (e.g. due to premature birth or moribund status) will be
excluded.
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