New Tecumseth

Researchers are investigating how real-time audio-video telemedicine consultations with a neonatologist, called teleneonatology, affect early health outcomes of at-risk newborns delivered in community hospitals. This multicenter study uses a stepped wedge cluster randomized design to assess the impact of teleneonatology on early mortality, morbidity, and delivery room care in these newborns. The study involves connecting a neonatologist in a regional neonatal intensive care unit (NICU) with physicians in community hospitals through a live, two-way audio-video telemedicine system. This connection allows neonatologists to provide advanced support during neonatal resuscitations remotely. The study focuses on neonates born at less than 32 weeks gestation or those needing advanced resuscitation such as prolonged positive pressure ventilation, alternative airway placement, or chest compressions. Participants will include both community hospital clinicians attending newborn resuscitations and the at-risk neonates meeting the inclusion criteria. Researchers will measure outcomes such as the 7-day mortality rate to evaluate the effect of teleneonatology. The study excludes neonates with severe congenital anomalies requiring early intensive care or surgery, those receiving comfort care only, and cases where an in-person neonatologist or transport team is present at birth.