developing a teleneonatology program in response to covid-19
TRANSCRIPT
Developing a Teleneonatology Program in Response to COVID-19Ses s ion # 85, Augus t 11, 2021
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Clinical Director, Liverpool Neonatal PartnershipLiverpool Women’s Hospital and Alder Hey Children’s Hospital Liverpool, United Kingdom
Chris Dewhurs t , MD
DISCLAIMER: The views and opinions expressed in this presentation are solely those of the author/presenter and do not necessarily represent any policy or position of HIMSS.
Operations Manager, Teleneonatology ProgramAssistant Professor of Healthcare AdministrationMayo ClinicRochester, MN, USA
Beth Kreofs ky, MBA
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Welcome
Operations Manager, Teleneonatology ProgramAssistant Professor of Healthcare Administration
Mayo ClinicRochester, MN, USA
Beth Kreofs ky, MBAClinical Director, Liverpool Neonatal Partnership,
Liverpool Women’s Hospital and Alder Hey Children’s Hospital
Liverpool, United Kingdom
Chris Dewhurs t , MD
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#HIMSS21
Conflict of Interest
Chris Dewhurst, MD
Has no real or apparent conflicts of interest to report.
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Conflict of Interest
Beth Kreofsky, MBA
Has no real or apparent conflicts of interest to report.
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Agenda
• Learning Objectives
• Mayo Clinic Teleneonatology Program
• Collaboration with Liverpool Neonatal Partnership
• Rapid Implementation of Teleneonatology During Pandemic Onset
• Outcomes
• Lessons Learned
• Future Development
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Learning Objectives• Identify how a telehealth program can be set up quickly, safely, and
effectively in response to a pandemic
• Describe the benefits of a partnership between health providers and academic researchers in developing a telehealth program
• Recognize how a telehealth solution can support clinical decision-making in a remote setting
• Analyze the operational success and workforce response to a telehealth program
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• A telemedicine network that allows neonatologists to be at the bedside of critically ill neonates exactly when needed• Improves access to
neonatal expertise• Facilitates patient triage• Improves patient safety
and quality of care
Teleneonatology
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Mayo Clinic
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Mayo Clinic Teleneonatology“RIGHT CARE, RIGHT PLACE, RIGHT TIME”
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Teleneonatology in Practice
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2014
Stabilization Initiatives and
Communication
Program Operations
and ExpansionAll Quality
Improvement Efforts Placed on Hold due To COVID; Assistance With Mayo Clinic Telehealth
Implementations; International
Collaborations
Evolution of Teleneonatology at Mayo Clinic
20132015
2017
20192021
2016
2018 2020
Expansion and Research, Partner
with Academic Research Advisor
Program Inception
Process Improvement
and Staff Engagement
Program Strategy Development and
Maintenance
Program Expansion
Quality Improvement Reinstated;
Collaborations and Research
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Establishing a TeleneonatologyProgram in 5 Weeks
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Urgent Need
Expert Guidance
Rapid Implementation
Liverpool Neonatal Partnership
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• Two site model “Liverpool Neonatal Partnership”
• All modalities, including surgery, cardiac, fetal medicine
• Liverpool Women’s Hospital (LWH)• Approximately 8,000 deliveries• 44-cot NICU
• Alder Hey Children’s Hospital (AHCH)• Largest children’s hospital in UK• 9-cot surgical unit• PICU, Cardiac, ECMO
Liverpool Neonatal Care
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• 22-cot NICU opening in 2023• Surgical (General, neuro, ENT,
cardiac)• Single workforce across both sites
(LWH and AHCH)• Working with industry partners• “World class neonatal unit” with
all single-family rooms
AHCH Neonatal Intensive Care Development
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• Telehealth Symposium• Jennifer Fang, M.D., Medical
Director, Teleneonatology, Mayo Clinic
• Network support, resuscitation/stabilisation
Spring 2020—Monday, 2 March
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Teleneonatology in Practice
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Spring 2020—Friday, 7 March
Coronavirus News• European Wave• 2nd death in UK• "It's coming"
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“Dr Fauzia PaizeConsultant Neonatologist, Liverpool
Women’s Hospital
Get the telemedicine system….we are going to need it.
Spring 2020—Friday, 7 March
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• UK lockdown and Impact on Neonatal Unit• Usually very low level of
consultant staff sickness• Prior to lockdown: 3/14
consultants on long-term leave
• Lockdown: 7/14 consultants sick/isolating/shielding
• Loss of approximately 40% of clinical facing time
• Two site service unsustainable
Spring 2020—Monday, 23 March
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• Telemedicine vendor• IT departments both sites• IG approval• How, where, when, why?!
Simon Minford ANP, innovation consultant Alder Hey Children's Hospital
Spring 2020—Tuesday, 24 March
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• Implementation• Training: Virtual to those at home• Restructured work patterns =
“Virtual Consultant”• Shielding neonatologists
• Virtual Neonatologist• Ward round into AHCH surgical unit• Full special care baby unit (SCBU)• Ad hoc support into postnatal ward and
fetal medicine• Virtual Surgeons: remote access
ward rounds into LWH
Spring 2020—Monday, 6 April
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Teleneonatology Implemented in 4 Weeks
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2 March March 23 March 24 March 6 April
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Benefits of a PandemicThe Rules Change
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Regula t ions Loos en Las er Focus Knowledge Sharing Technology
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Impact
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Approximately 140 virtual sessions/month using the system
Approximately £33k/month in savings
Teamwork —staff who can't be on site feel like part of the team
Program has been welcomed by parents —excellent feedback
5 Recognized by national awards
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• Change in Need• In-person newborn care is still the
gold standard• Ability to spend time defining the
true need• Assistance in peripheral hospitals
versus coverage of NICUs
• Technology serves its purpose • Now the choice is redeployment
for where the need was pre-pandemic
What Next?—The Hard Work Starts Now
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Collaboration
Grow the Liverpool Women’s Hospital, Alder Hey and Mayo Clinic relationship 1
Research impact on health outcomes with academic advisory 3
Explore other opportunities in UK and Europe2
Further communicate framework for implementing acute -care telemedicine4
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ReplicabilityAnalyze, Organize and Share
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Identify the Need and Validate
Mentor through Clinical Experience
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Conclusions
Expert guidance allows impactful, effective telehealth solutions1
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Reduces the time and cost associated with program start -up and adoption2
Teleneonatology is effective under normal circumstances and in times of crisis and disruption.4
Time is not a barrier to implementation when there is an urgent need
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“The glory of medicine is that it is constantly moving forward, that there is always more to learn.”William J. Mayo
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Questions
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Thank you!• Chris Dewhurst, MD
Clinical Director, Liverpool Neonatal PartnershipLiverpool Women’s Hospital and Alder Hey Children’s Hospital [email protected]://www.linkedin.com/in/chris-dewhurst-8ab899110/
• Beth Kreofsky, MBAOperations Manager, Teleneonatology ProgramAssistant Professor of Healthcare AdministrationMayo Clinic
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