Preliminary evaluation of a system for neonatal teleconsultation

Abstract

We assessed the efficacy of a system for teleconsultation in the care of newborns via real-time video (NEMO, Neonatal Examination and Management Online). The study was conducted in the controlled environment of a tertiary neonatal intensive care unit (NICU) before deployment for trial in remote hospitals. Eight ventilated infants were studied (their parents providing consent). A range of clinical tasks were completed by 14 medical staff. These included visual assessment of respiratory rate and perfusion, gathering of data from cot-side equipment, and the capture and interpretation of an X-ray image from an LCD screen. In total, 854 tests were completed using the system. In the visual infant assessment phase, 100% of participants read the endotracheal tube taped distance accurately within 1 cm, while agreement between participants and control on respiration rate (within 5 breaths/min) was 93%. When reviewing an X-ray image captured from an LCD screen, 85% of participants agreed with the control regarding endotracheal tube placement (high, normal or low). The results show that the NEMO system provides an efficacious means of presenting tertiary neonatal specialists with timely information beyond that currently available by ordinary telephone.