Developing a Newborn Resuscitation Telemedicine Program: A Follow-Up Study Comparing Two Technologies

Abstract

<b><i>Background:</i></b> Early work has demonstrated that newborn resuscitation telemedicine programs (NRTPs) are feasible and improve the quality of high-risk newborn resuscitations in community settings. Research evaluating the telemedicine technology requirements for NRTPs is limited. <b><i>Objective:</i></b> To compare the quality and reliability of two telemedicine technologies for providing NRTP consults. We hypothesized that the InTouch Lite Version 2 (ITH Lite) would provide a higher-quality user experience and superior reliability when compared with a wired telemedicine cart. <b><i>Methods:</i></b> From December 1, 2015 to August 31, 2017, providers completed electronic surveys assessing technology performance after each NRTP consult and incident reporting/resolution was monitored. Survey questions assessed the overall, audio, and video quality using a 1-5 Likert scale. Reliability was assessed based on the ability to connect on first-attempt, unplanned disconnections, and the frequency and impact of reported incidents. <b><i>Results:</i></b> During the study period, 118 NRTP consults were performed (n<i> = 25 wired cart;</i> n<i> = 93 ITH Lite) and 155 surveys were completed (</i>n<i> = 26 wired cart;</i> n<i> = 129 ITH Lite). Overall and video quality were similar between the two technologies, but audio quality (mean ± standard deviation) was superior using the ITH Lite (4.61 ± 0.72 vs. 4.08 ± 1.13,</i> p <i>< 0.01). Ability to connect on first attempt was improved with the ITH Lite (96% vs. 73%,</i> p <i>< 0.01). Fewer incidents were reported per activation (0.5:1 vs. 0.9:1) and more incidents were proactively resolved using the ITH Lite (93% vs. 68%,</i> p <i>< 0.01).</i><b><i>Conclusion:</i></b> The ITH Lite demonstrated improved audio quality and reliability when compared with a wired cart. Organizations should consider connection reliability and audio/video quality when selecting a NRTP technology.