Babies delivered at rural hospitals can receive specialized neonatal care through a unique telehealth program

A newborn baby's care team can get live, immediate help
from a neonatologist with TeleICN. (Dartmouth photo)

A pregnancy delivery in a rural hospital far away from specialized care poses significant risks for a baby born with complex needs. In Vermont and New Hampshire, Dartmouth Health created TeleICN, a unique telehealth program that connects rural medical providers to neonatologists who can help manage a baby's health during and after delivery, reports Christopher Cheney for Healthleaders.

As more rural hospitals have cut services to save money, many have shuttered their labor and delivery units. In the case of an emergency delivery, EMS will take a pregnant patient to the nearest emergency department, where a rural care team can "connect to the TeleICN program using an iPad or making a phone call," Cheney explains.

Tapping into TeleICN is similar to using FaceTime. The program allows a neonatologist to "talk with the local teams, look at the baby via video, and work with the mom and their family members to make decisions about the next steps in care for babies," Cheney reports. TeleICN can "connect local care teams to a neonatologist virtually on a 24/7 basis, and it serves 16 rural hospitals in New Hampshire and Vermont."

Katelyn Darling, a director at Dartmouth Health, shared the varying levels of care TeleICN often provides, saying, "Sometimes, they know a mom in labor is on the way to their hospital, and they want us to help them prep the care room. Sometimes, they want us in the background to support them. Sometimes, they want us on the frontline making decisions about care."

Because the TeleICN has been so successful, Dartmouth expanded its virtual obstetrics care with its new TeleMFM program. Cheney explains, "The focus is on high-risk obstetrics care and fetal-maternal medicine services, with the goal of reducing the need for patients to travel long distances. … Patients can go to a clinic associated with a rural hospital and get connected to a TeleMFM provider."

Jessica Clem, TeleICN's medical director, told Healthleaders, "What we are trying to do is provide equitable care in New Hampshire and Vermont, particularly for rural communities."