title: Emergency Video Telemedicine Consultation for Newborn Resuscitations: The Mayo Clinic Experience.
abstract: OBJECTIVE
  To describe the Mayo Clinic experience with emergency video telemedicine consultations for high-risk newborn deliveries.
  
  
  METHODS
  From March 26, 2013, through December 31, 2015, the Division of Neonatal Medicine offered newborn telemedicine consultations to 6 health system sites. A wireless tablet running secure video conferencing software was used by the local care teams. Descriptive data were collected on all consultations. After each telemedicine consult, a survey was sent to the neonatologist and referring provider to assess the technology, teamwork, and user satisfaction.
  
  
  RESULTS
  During the study, neonatologists conducted 84 telemedicine consultations, and 64 surveys were completed. Prematurity was the most frequent indication for consultation (n=32), followed by respiratory distress (n=15) and need for advanced resuscitation (n=14). After the consult, nearly one-third of the infants were able to remain in the local hospital. User assessment of the technology revealed that audio and video quality were poor or unusable in 16 (25%) and 12 (18.8%) of cases, respectively. Providers failed to establish a video connection in 8 consults (9.5%). Despite technical issues, providers responded positively to multiple questions assessing teamwork (86.0% [n=37 of 43] to 100.0% [n=17 of 17] positive responses per question). In 93.3% (n=14 of 15) of surveyed cases, the local provider agreed that the telemedicine consult improved patient safety, quality of care, or both.
  
  
  CONCLUSIONS
  Telemedicine consultation for neonatal resuscitation improves patient access to neonatology expertise and prevents unnecessary transfers to a higher level of care. A highly reliable technology infrastructure that provides high-quality audio and video should be considered for any emergency telemedicine service.
authors.affiliation: Division of Neonatal Medicine, Mayo Clinic, Rochester, MN. Electronic address: fang.jennifer@mayo.edu.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Fang
authors.affiliation: Division of Neonatal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Collura
authors.affiliation: Division of Neonatal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Robert V
authors.initials: RV
authors.lastname: Johnson
authors.affiliation: Division of Neonatal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Garth F
authors.initials: GF
authors.lastname: Asay
authors.affiliation: Division of Neonatal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: William A
authors.initials: WA
authors.lastname: Carey
authors.affiliation: Division of Neonatal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Derleth
authors.affiliation: Division of Neonatal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Tara R
authors.initials: TR
authors.lastname: Lang
authors.affiliation: Center for Connected Care, Mayo Clinic, Rochester, MN.
authors.forename: Beth L
authors.initials: BL
authors.lastname: Kreofsky
authors.affiliation: Division of Neonatal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Colby
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002983:Clinical Competence; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012017:Referral and Consultation; D019114:Remote Consultation / Q000379:methods*; D017216:Telemedicine / Q000379:methods*; D049269:Videoconferencing