title: ANGELS and University of Arkansas for Medical Sciences paradigm for distant obstetrical care delivery.
abstract: OBJECTIVE
  This article describes the process by which the Arkansas Medicaid Program, the University of Arkansas for Medical Sciences (the state's only academic health center), and Arkansas' practicing physicians are collaborating to improve the process of perinatal regionalization by providing access to expertise, education, and support of maternal-fetal medicine specialists. The described ANGELS model encourages replication among other programs that wish to improve perinatal regionalization attempts in their service areas.
  
  
  METHODS
  Through this unique collaboration, ANGELS is composed of 5 distinctive elements: a statewide telemedicine and clinic network, an education and support program for obstetric providers, case management services, a 24-hour Call Center, and an evidence-based guidelines development and distribution network.
  
  
  RESULTS
  Since Arkansas has undertaken perinatal regionalization, technology has allowed the state's only group of board-certified maternal-fetal medicine specialists, located centrally in Little Rock, to provide real-time clinical support to physicians, as well as consultation or direct care to patients statewide.
  
  
  CONCLUSIONS
  ANGELS' continued efforts have the potential to significantly improve perinatal care in rural areas throughout the state, while the cost of maternal and fetal health care could decline. The program's design, although unique, can be replicated elsewhere to encourage perinatal regionalization.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. lowerycurtisl@uams.edu
authors.forename: Curtis
authors.initials: C
authors.lastname: Lowery
authors.forename: Janet
authors.initials: J
authors.lastname: Bronstein
authors.forename: Judith
authors.initials: J
authors.lastname: McGhee
authors.forename: Rachel
authors.initials: R
authors.lastname: Ott
authors.forename: E Albert
authors.initials: EA
authors.lastname: Reece
authors.forename: Glen P
authors.initials: GP
authors.lastname: Mays
mesh_terms: D000046:Academic Medical Centers; D001131:Arkansas; D019090:Case Management / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008484:Medicaid; D009774:Obstetrics / Q000193:education / Q000458:organization & administration; D018743:Perinatal Care / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D015397:Program Evaluation; D012041:Regional Medical Programs / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D017216:Telemedicine / Q000458:organization & administration* / Q000706:statistics & numerical data; D014187:Transportation of Patients / Q000458:organization & administration / Q000706:statistics & numerical data