Developing a Teleneonatology Program in Response to COVID-19Ses s ion # 85, Augus t 11, 2021

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Clinical Director, Liverpool Neonatal PartnershipLiverpool Women’s Hospital and Alder Hey Children’s Hospital Liverpool, United Kingdom

Chris Dewhurs t , MD

DISCLAIMER: The views and opinions expressed in this presentation are solely those of the author/presenter and do not necessarily represent any policy or position of HIMSS.

Operations Manager, Teleneonatology ProgramAssistant Professor of Healthcare AdministrationMayo ClinicRochester, MN, USA

Beth Kreofs ky, MBA

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Welcome

Operations Manager, Teleneonatology ProgramAssistant Professor of Healthcare Administration

Mayo ClinicRochester, MN, USA

Beth Kreofs ky, MBAClinical Director, Liverpool Neonatal Partnership,

Liverpool Women’s Hospital and Alder Hey Children’s Hospital

Liverpool, United Kingdom

Chris Dewhurs t , MD

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#HIMSS21

Conflict of Interest

Chris Dewhurst, MD

Has no real or apparent conflicts of interest to report.

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#HIMSS21

Conflict of Interest

Beth Kreofsky, MBA

Has no real or apparent conflicts of interest to report.

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Agenda

• Learning Objectives

• Mayo Clinic Teleneonatology Program

• Collaboration with Liverpool Neonatal Partnership

• Rapid Implementation of Teleneonatology During Pandemic Onset

• Outcomes

• Lessons Learned

• Future Development

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#HIMSS21

Learning Objectives• Identify how a telehealth program can be set up quickly, safely, and

effectively in response to a pandemic

• Describe the benefits of a partnership between health providers and academic researchers in developing a telehealth program

• Recognize how a telehealth solution can support clinical decision-making in a remote setting

• Analyze the operational success and workforce response to a telehealth program

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• A telemedicine network that allows neonatologists to be at the bedside of critically ill neonates exactly when needed• Improves access to

neonatal expertise• Facilitates patient triage• Improves patient safety

and quality of care

Teleneonatology

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Mayo Clinic

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Mayo Clinic Teleneonatology“RIGHT CARE, RIGHT PLACE, RIGHT TIME”

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Teleneonatology in Practice

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2014

Stabilization Initiatives and

Communication

Program Operations

and ExpansionAll Quality

Improvement Efforts Placed on Hold due To COVID; Assistance With Mayo Clinic Telehealth

Implementations; International

Collaborations

Evolution of Teleneonatology at Mayo Clinic

20132015

2017

20192021

2016

2018 2020

Expansion and Research, Partner

with Academic Research Advisor

Program Inception

Process Improvement

and Staff Engagement

Program Strategy Development and

Maintenance

Program Expansion

Quality Improvement Reinstated;

Collaborations and Research

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Establishing a TeleneonatologyProgram in 5 Weeks

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Urgent Need

Expert Guidance

Rapid Implementation

Liverpool Neonatal Partnership

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• Two site model “Liverpool Neonatal Partnership”

• All modalities, including surgery, cardiac, fetal medicine

• Liverpool Women’s Hospital (LWH)• Approximately 8,000 deliveries• 44-cot NICU

• Alder Hey Children’s Hospital (AHCH)• Largest children’s hospital in UK• 9-cot surgical unit• PICU, Cardiac, ECMO

Liverpool Neonatal Care

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• 22-cot NICU opening in 2023• Surgical (General, neuro, ENT,

cardiac)• Single workforce across both sites

(LWH and AHCH)• Working with industry partners• “World class neonatal unit” with

all single-family rooms

AHCH Neonatal Intensive Care Development

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• Telehealth Symposium• Jennifer Fang, M.D., Medical

Director, Teleneonatology, Mayo Clinic

• Network support, resuscitation/stabilisation

Spring 2020—Monday, 2 March

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Teleneonatology in Practice

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Spring 2020—Friday, 7 March

Coronavirus News• European Wave• 2nd death in UK• "It's coming"

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“Dr Fauzia PaizeConsultant Neonatologist, Liverpool

Women’s Hospital

Get the telemedicine system….we are going to need it.

Spring 2020—Friday, 7 March

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• UK lockdown and Impact on Neonatal Unit• Usually very low level of

consultant staff sickness• Prior to lockdown: 3/14

consultants on long-term leave

• Lockdown: 7/14 consultants sick/isolating/shielding

• Loss of approximately 40% of clinical facing time

• Two site service unsustainable

Spring 2020—Monday, 23 March

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• Telemedicine vendor• IT departments both sites• IG approval• How, where, when, why?!

Simon Minford ANP, innovation consultant Alder Hey Children's Hospital

Spring 2020—Tuesday, 24 March

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• Implementation• Training: Virtual to those at home• Restructured work patterns =

“Virtual Consultant”• Shielding neonatologists

• Virtual Neonatologist• Ward round into AHCH surgical unit• Full special care baby unit (SCBU)• Ad hoc support into postnatal ward and

fetal medicine• Virtual Surgeons: remote access

ward rounds into LWH

Spring 2020—Monday, 6 April

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Teleneonatology Implemented in 4 Weeks

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2 March March 23 March 24 March 6 April

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Benefits of a PandemicThe Rules Change

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Regula t ions Loos en Las er Focus Knowledge Sharing Technology

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Impact

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Approximately 140 virtual sessions/month using the system

Approximately £33k/month in savings

Teamwork —staff who can't be on site feel like part of the team

Program has been welcomed by parents —excellent feedback

5 Recognized by national awards

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• Change in Need• In-person newborn care is still the

gold standard• Ability to spend time defining the

true need• Assistance in peripheral hospitals

versus coverage of NICUs

• Technology serves its purpose • Now the choice is redeployment

for where the need was pre-pandemic

What Next?—The Hard Work Starts Now

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Collaboration

Grow the Liverpool Women’s Hospital, Alder Hey and Mayo Clinic relationship 1

Research impact on health outcomes with academic advisory 3

Explore other opportunities in UK and Europe2

Further communicate framework for implementing acute -care telemedicine4

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ReplicabilityAnalyze, Organize and Share

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Identify the Need and Validate

Mentor through Clinical Experience

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Conclusions

Expert guidance allows impactful, effective telehealth solutions1

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Reduces the time and cost associated with program start -up and adoption2

Teleneonatology is effective under normal circumstances and in times of crisis and disruption.4

Time is not a barrier to implementation when there is an urgent need

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“The glory of medicine is that it is constantly moving forward, that there is always more to learn.”William J. Mayo

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Questions

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Thank you!• Chris Dewhurst, MD

Clinical Director, Liverpool Neonatal PartnershipLiverpool Women’s Hospital and Alder Hey Children’s Hospital Christopher.Dewhurst@lwh.nhs.ukhttps://www.linkedin.com/in/chris-dewhurst-8ab899110/

• Beth Kreofsky, MBAOperations Manager, Teleneonatology ProgramAssistant Professor of Healthcare AdministrationMayo Clinic

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