Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2026
Neonatal CATCH Program: Remote Monitoring Benefits Medically Complex Infants at Home.
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Chuo John, Spotts Lori, Smith Kristen, White Meredith, Perkins Jennifer, Boyle Jess, Oluwalade Bolu, Coyle Matthew, Hadley Sarah, Preminger Tamar, Desai Bimal
Аннотация
BACKGROUND: Medically complex infants comprise a small fraction of births yet account for disproportionate health care utilization after neonatal intensive care unit (NICU) discharge. We evaluated a 30-day postdischarge remote patient management (RPMT) program-Neonatal Collaborative Assistance and Telehealth for Complex Homecare (CATCH)-combining remote therapeutic monitoring and structured caregiver support.
METHODS: In a pragmatic, staged rollout (March 2023 to February 2025), we prospectively followed eligible NICU graduates discharged on tube feeds, yielding two cohorts: enrolled (E) and not enrolled (NE), plus a historical "would-have-been-eligible" cohort. Interventions included telemedicine visits, bidirectional text message check-ins, and collaboration with primary and subspecialty care teams. Outcomes were 30-day readmission (RA30), 30-day ED visit (EDV30), frequency and types of interventions, Net Promoter Score, and weight gain. Analyses used statistical process control (SPC) methods, bivariate tests, and logistic regression modeling.
RESULTS: Three hundred and two and 254 infants were, respectively, E and NE during CATCH implementation, plus 853 historical controls for a total of 1,409 eligible infants. Mean weight gain did not differ (18.8 vs. 22.3 g; p = 0.28). RA30 was lower in E versus NE (13% vs. 22%; p < 0.01), and EDV30 was lower in E versus NE (21% vs. 28%; p = 0.08). Regression and inferential statistics provided a deeper understanding, complemented by SPC time charts that included comparison with historical cohort. At least one "good catch" intervention occurred in 23% of enrolled infants with the majority closing communication gaps among health care team members; net promoter score was 89.
CONCLUSIONS: A structured RPMT program immediately after NICU discharge was associated with lower 30-day readmissions, beneficial interventions, and was highly recommended by families. Future studies and actions must address social determinants such as interpreter access.
METHODS: In a pragmatic, staged rollout (March 2023 to February 2025), we prospectively followed eligible NICU graduates discharged on tube feeds, yielding two cohorts: enrolled (E) and not enrolled (NE), plus a historical "would-have-been-eligible" cohort. Interventions included telemedicine visits, bidirectional text message check-ins, and collaboration with primary and subspecialty care teams. Outcomes were 30-day readmission (RA30), 30-day ED visit (EDV30), frequency and types of interventions, Net Promoter Score, and weight gain. Analyses used statistical process control (SPC) methods, bivariate tests, and logistic regression modeling.
RESULTS: Three hundred and two and 254 infants were, respectively, E and NE during CATCH implementation, plus 853 historical controls for a total of 1,409 eligible infants. Mean weight gain did not differ (18.8 vs. 22.3 g; p = 0.28). RA30 was lower in E versus NE (13% vs. 22%; p < 0.01), and EDV30 was lower in E versus NE (21% vs. 28%; p = 0.08). Regression and inferential statistics provided a deeper understanding, complemented by SPC time charts that included comparison with historical cohort. At least one "good catch" intervention occurred in 23% of enrolled infants with the majority closing communication gaps among health care team members; net promoter score was 89.
CONCLUSIONS: A structured RPMT program immediately after NICU discharge was associated with lower 30-day readmissions, beneficial interventions, and was highly recommended by families. Future studies and actions must address social determinants such as interpreter access.