b'REDUCING TRANSFERS WITHOUT COMPROMISING QUALITY USING TELENICU. In a state where it takes nearly 14 hours to drive from top to bottom, transferring every neonate to the Level IV NICU at Childrens Medical Center Dallas wouldnt just be inefficient it would be nearly impossible. Thats why Childrens Health and UT Southwestern developed one of the nations most comprehensive TeleNICU programs. Along the way, we solved compliance and legal problems, built our own platform and created a model that makes it affordable for partner hospitals to get input from our specialists. Its a win for families because it keeps them closer to home, and its a win for the health care system, because it lowers costs and lets smaller hospitals keep more neonates at their facility, says Dr. Rashmin Savani. STEP ONE: WORK WITH EXPERTS AS A COLLABORATIVE TEAM.We spent two years developing privacy safeguards, custom software and tackling other key challenges before launching TeleNICU by Childrens Health Virtual Care. Our first step As one of the busiest transport teams in the country, the Childrens Health NICU nurses, was to create a working group that met weekly. The group collaborated with medical, legal, paramedics and respiratory therapists on transit quickly adopted TeleTransport and TeleCooling. compliance and technology experts, and we devised ways to:Efficiently gain parental consent for virtual care Literally speaking, time is brain says Dr. Chalak. We invested in FDA-approved technologyEnsure compliance with HIPAA, the Centers for Medicare & Medicaid Services and thethat allows active cooling on transport and trained the team on the use of this cooling deviceTexas Medical Boardas a part of the TeleTransport program.Establish an efficient process to get physicians credentialed The sooner the cooling begins, the better the babys chances. at the hospitals where they would be consultingTo determine what babies qualify for this intervention, we need to be able to examine themEstablish a secure way to transfer medical data, such as remotely, says Dr. Dariya. Then, with certainty, we can tell our transport team, Start coolingX-rays, ECHO and EEGthis baby now. The baby can then be actively cooled during transport, starting this criticalThe next step was finding software that would meet our therapy sooner. performance, privacy and security standards. After testing IMAGINING THE FUTURE OF TELETRANSPORT. several programs, we opted to build our own platform, which gave us full control over the end product. TeleTransport marks the latest milestone in our push to extend Level IV care to babies across our region. In partnership with UT Southwestern, we developed one of the nations mostSTEP TWO: USE STATE-OF-THE-ART TOOLScomprehensive TeleNICU programs in 2013. Weve virtually examined more than 200 neonatesFOR REMOTE EXAMS.so far, and more than half of those patients have been able to remain in their home hospitals. Now were looking for ways to virtually connect with more patients and more providers. Our mobile carts include digital otoscopes and stethoscopes, high-resolution cameras and a video laryngoscope. This enables The underlying principle is that we want to extend the reach of our level of care, whilethe neonatologists here to conduct thorough exams from afar, collaborating with doctors at referring hospitals to enhance treatment, Dr. Savani says. and we can even give real-time input on things like how a distant The next goal is to provide TeleTransport capability on any and every transport, says Dr.team should intubate an infant. Dariya. And not just for the NICU. My hope is that our colleagues in the ER, Pediatric ICU andIt means we can help outside providers pinpoint a babysThe Transport teams Jimmy Puga and Frank Moreno CVICU all find benefit doing this. Any service within this hospital should have the ability tocondition and find ways to keep them stable, Dr. Savani says.were instrumental in the planning and implementation evaluate a sick patientbefore they get here. process of bringing this innovation to Texas familiesand referring hospitals.'