Unforeseen Positive Impacts of a Neonatal Encephalopathy Teleconsultation Program: Insights From Clinicians Practicing in a Rural State.

BACKGROUND

Virtual triaging using telemedicine has been associated with improved communication, efficiency and accessibility, and reduced costs of care delivery. The Maine Neonatal Encephalopathy Teleconsultation (Maine NET) Program was developed to provide these advantages to neonates in rural areas. In previous work, we discussed improved resource utilization, collaborative decision-making, communication, and continuity of care associated with Maine NET. Herein, we examine additional, unexpected themes related to the psychosocial impacts of Maine NET on participating clinicians.

METHODS

We performed semistructured interviews from April 2018 to October 2022 with 16 clinicians representing all hospitals participating in Maine NET. We utilized hybrid thematic analysis to assess themes from transcribed interviews.

RESULTS

Several themes of Maine NET were identified in this analysis, including reduced feelings of isolation, alleviation in intensity of time pressure, heightened stress and trauma related to caring for the newborns requiring resuscitation, increased equity and access to subspecialty care, and opportunities for education. One clinician stated that "…it's lonely at the top [when] you're in a rural community hospital running the show and it's always scary to make these big decisions…so having somebody share that … is super helpful for moral support."

CONCLUSIONS

The Maine NET Program provided several unanticipated benefits to both patients and the clinicians caring for them. As rural states increasingly face health care workforce shortages, availability of teleconsultation may support physician recruitment and retention in low delivery volume hospitals as it improves care delivery and facilitates connection to pediatric specialists, reducing isolation and increasing opportunities for ongoing education.