Reducing Infant Mortality Using Telemedicine and Implementation Science

[Telemedical Support of Feto-Neonatal Care in One Region - Part I: Demand Analysis Using the Example of East Saxony]

Excellence in feto-neonatal care forms the basis for health in adulthood and requires a collaboration of stakeholders in the health care system. As in other regions, demographic changes such as rural depopulation pose a risk to feto-neonatal care in Eastern Saxony. Areas in need of regional, perinatal collaboration have been identified: (I) multi-professional counselling of families with a suspected fetal disease, (II) immediately available expertise of a neonatologist during neonatal resuscitation, (III) evidence-based neonatal antibiotic therapy, (IV) backtransfer of extremely preterm infants or sick neonates, and (V) adequate psychosocial support of families with extremely preterm infants or sick neonates. Telemedicine enables regional partners to communicate efficiently and gives an audiovisual impression of the patient. The Saxony Center for feto/neonatal Health (SCFNH) collaborates with regional partners to establish a feto-neonatal telemedicine network "Sichere Geburt". The network will be scientifically evaluated and might be of help as a model for other regions with structural challenges.

The Impact of Telemedicine in the Diagnosis of Erythema Migrans during the COVID Pandemic: A Comparison with In-Person Diagnosis in the Pre-COVID Era

Background: Erythema migrans (EM) is the hallmark manifestation of the Lyme borreliosis (LB), and therefore its presence and recognition are sufficient to make a diagnosis and to start proper antibiotic treatment to attempt to eradicate the infection. Methods: In this study we compared the clinical data of 439 patients who presented an EM either according to the diagnostic modality through physical assessment or through telemedicine. Conclusions: Our data clearly show that telemedicine for EM diagnosis is useful as it enables prompt administration of appropriate antibiotic therapy, which is critical to avoid complications, especially for neurologic and articular entities. Therefore, telemedicine is a tool that could be adopted for the diagnosis of Lyme disease both by specialized centers but also by general practitioners.

Telehealth to Improve Perinatal Care Access

ABSTRACT

The United States has the worst maternal mortality rate of peer countries. Since 1935, the maternal mortality risk among Black women has remained three to four times higher than that of White women. Perinatal health care is not available in all areas, which limits the access for certain groups. Many women in the United States live in maternity care deserts with no access to obstetric providers, whereas others live in areas with very limited access. One way to bridge the gap between effective perinatal care and access to care is use of telehealth. Telehealth allows health care providers to communicate directly with patients that cannot physically be seen in a clinic or hospital. Telehealth is endorsed by the American College of Obstetricians and Gynecologists as an alternate mode to deliver prenatal and postpartum services. The potential for telehealth services as part of perinatal care to reduce maternal and neonatal morbidity and mortality by improving access to care is presented.