Avera CareView
Sioux Falls, SD (October 12, 2007) - Infants born at rural sites will now benefit from neonatal expertise in the Avera Children's Hospital Neonatal Intensive Care Unit through a new telemedicine service known as Avera CareView.
The importance of this service became clear during a March 2005 blizzard, when weather prevented a premature infant born at Avera St. Benedict's Hospital in Parkston, S.D., from being transported either by ground ambulance or air.
In the early morning hours of March 13, 2005, Melissa Frey of Kaylor, S.D., went into premature labor. Her husband, Kurtis, drove her the 23 miles through a snowstorm to Avera St. Benedict, where she delivered her son, Everett, at 28 weeks.
Denise Muntefering, vice president of patient services and director of nursing at Avera St. Benedict, said she knew something was going on when she saw two physicians' cars parked at the hospital before 7 a.m. The Parkston team had already contacted Avera McKennan Hospital & University Health Center, talking by phone with a perinatologist and neonatologist. With blowing snow conditions, it was impossible to transport the baby either by helicopter or by ambulance.
Everett weighed 2 pounds, 8 ounces at birth. At such a small size, he needed to be intubated to support his ventilation. With specialist support by telephone, Parkston physicians successfully stabilized Everett. In the meantime, Avera Children's Hospital NICU staff called the telemedicine staff at Avera McKennan, which immediately took steps to establish an interactive video connection. Neonatologists in conjunction with the physicians at Avera St. Benedict then managed the baby's case throughout the hours before he could be transported to Avera Children's Hospital, which is part of Avera McKennan.
"For me, the most reassuring thing was I could go to his mom and say they've connected with Avera McKennan, and specialists are helping deliver care to your newborn baby," Muntefering said.
Avera St. Benedict is a small, rural hospital which provides excellent care, Mrs. Frey said. "Yet it was comforting to know the specialists at Avera McKennan were available."
After about six hours, when the weather had cleared enough, Everett was brought to Avera McKennan where he spent 137 days in the Level III NICU. He is now a toddler, nearly 18 months old. He is healthy, although he still deals with health issues that come along with being born premature.
Knowing that there are times when a baby cannot be transported immediately, or that an immediate consult may improve a baby's chances for survival, the NICU team will offer telemedicine consults on a consistent basis. Besides Parkston, connections have also been established at rural hospitals in Estherville, Iowa, and Pipestone, Minn.
Equipment in the Avera McKennan NICU involves a computer monitor with a camera mounted on top. Rural sites are equipped with a portable video unit. Cameras can zoom in to give greater detail, to read a gauge, or see a specific site on the infant's body.
Benefits of the program include increased access to specialty health care, support of rural health care providers, triage capability to discern which patients should be transported, and comfort to families. "Rural health providers have to know a little of everything, and this is one of the ways we can support them as they handle these crises," said Marilyn Dahler, Avera McKennan clinical telemedicine coordinator. Hospitals or patients pay no fee for the initial consultation to stabilize an infant or for triage purposes.
Telehealth at Avera McKennan dates back to 1993, with initial funding from grant projects. Since, Avera McKennan has emerged as a state leader in clinical consultations through telemedicine. Over 25 clinicians provide consults in 16 medical specialties, such as nephrology, pediatric pulmonology and cardiology, perinatology, endocrinology and oncology.
Telemedicine is a component of the wider category of telehealth, which includes education, store and forward of digital images, telehomecare, remote intensive care monitoring, and Internet e-health information and consults.
