Telehealth links rural newborns with local neonatologists

EDMONTON — Physicians and nursing staff in eight central and northern Alberta nurseries are now using videoconference technology to access urgent advice from Stollery Children’s Hospital neonatologists to help manage the care of acutely ill newborns.

Health care providers at the rural hospitals can connect with the Stollery’s David Schiff Neonatal Intensive Care Unit (NICU) in Edmonton via Alberta Health Services’ Telehealth video-conferencing system. An on-call neonatologist can assist with advice and clinical decision-making, including whether a newborn should be transported to an NICU with a higher level of care.

“Previously, we used the telephone to consult with physicians about critically-ill newborns,” says Dr. Ernest Phillipos, Zone Section Chief of Newborn Health for the Northern Alberta Neonatal Program at the Stollery. “Thanks to immediate videoconferencing, we now have enhanced our ability to triage referrals, reduce the need for unnecessary transfers, or provide interim support to rural physicians and nursing staff until our NICU transport team arrives.”

Each rural site was provided with a portable Telehealth unit and had a data line installed in the labour and delivery department. The Telehealth unit can be moved to the newborn’s bedside where Stollery neonatologists can discuss treatment options with on-site physicians and staff.

In May 2014, High Level became the first site to pilot the Telehealth project, designed to increase support for rural nurseries. Since then, the service has been implemented at seven additional sites: Camrose, Cold Lake, Fort Vermilion, Hinton, Lloydminster, St. Albert and Wetaskiwin. All of these sites do not have access to a local pediatrician.

“Transporting a newborn to Edmonton can be extremely stressful on parents and often distances them from their support networks,” says Dr. Phillipos.

“Since implementing consults via Telehealth, we’ve had many cases where the neonatologist on call has been able to provide support to the rural physician and nursing staff to manage the newborn at their location, preventing an unnecessary transport of some newborns and their family. Of those babies still requiring transport, with videoconferencing, newborns are much more stable when they arrive to our critical care sites.”

Samantha Schmidt, 30, didn’t anticipate any complications when she delivered her fourth baby at the Northwest Health Centre in High Level. However, staff at the site were concerned her newborn, Karson, had a lung condition that made breathing difficult.

A neonatologist at the Stollery was consulted via Telehealth and, after being monitored overnight, a transport team was sent to transfer him to an Edmonton NICU. Karson received oxygen and was monitored for four days until he was discharged.

“I never expected that Karson would need to have the care he did, but I’m glad to know the supports are in place for situations like ours,” says Schmidt.

“As soon as he was born, he had access to a specialist in our own community; I always felt like Karson was getting the care he needed in High Level.”

Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than four million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.

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