Telemedicine for Advanced Neonatal Resuscitations in Community Hospitals: TELENEO Trial

Overview

About this study

The purpose of this study is to evaluate the impact of real-time audio-video telemedicine consults with a neonatologist (termed teleneonatology) on the early health outcomes of at-risk outborn neonates delivered in community hospitals. Study eligible at-risk outborn neonates include those born at < 32 weeks' gestation or those who require advanced resuscitation. This study will explore if teleneonatology reduces early mortality and morbidity and improves their delivery room care.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

GROUP 1: Community hospital physicians (N=275)

A physician who attends newborn resuscitations at a participating community hospital spoke site.
Provision of informed oral consent prior to any mandatory study specific procedures and analyses.

GROUP 2: At-risk outborn neonates (N=708)

Preterm birth at less than 32 weeks’ gestation at delivery; OR
Need for advanced resuscitation defined as:
- Positive pressure ventilation (PPV) initiated soon after birth and continued for at least 10 minutes; OR
- Placement of an alternative airway (endotracheal tube or laryngeal mask) to provide PPV; OR
- Chest compressions.

Exclusion Crtieria:

GROUP 2: At-risk outborn neonates (N=708)

Birth outside of the hospital birthing center.
Neonatal transport team present at time of birth and providing resuscitative care.
Severe congenital anomaly necessitating intensive care or surgery in the first two weeks of life.
Plan for comfort care (non-resuscitation) following delivery.
In-person neonatology-trained physician present for the resuscitation.

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Eligibility last updated 6/1/23. Questions regarding updates should be directed to the study team contact.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location	Status	Contact
Rochester, Minn. Mayo Clinic principal investigator Jennifer Fang, M.D.	Closed-enrolling by invitation What is this? (?) "Close" Not open to everyone who meets the eligibility criteria, but only those invited to participate by the study team.	Contact information: Meegan Van Straaten P.T. (507) 293-4948 VanStraaten.Meegan@mayo.edu

Mayo Clinic Location

Status

Contact

Rochester, Minn.

Mayo Clinic principal investigator

Jennifer Fang, M.D.

Closed-enrolling by invitation

Contact information:

Meegan Van Straaten P.T.

(507) 293-4948

VanStraaten.Meegan@mayo.edu

More information

Publications

We aimed to measure provider perspectives on the acceptability, appropriateness, and feasibility of teleneonatology in neonatal intensive care units (NICUs) and community hospitals. Read More on PubMed
Our research consortium is preparing for a prospective multicenter trial evaluating the impact of teleneonatology on the health outcomes of at-risk neonates born in community hospitals. We completed a 6-month pilot study to determine the feasibility of the trial protocol. Read More on PubMed
Clinical trials evaluating facility-to-facility telemedicine may include sites that have limited research experience. For the trial to be successful, these sites must correctly perform research-related tasks. This study aimed to determine whether health care professionals at community hospitals could accurately identify simulated study eligible patients and submit data to a research coordinating center. Twenty-seven community hospitals in the United States and Canada participated in this study. An electronic survey was sent to one designated health care professional at each site. The survey included a description of trial eligibility criteria and five written neonatal resuscitation scenarios. For each scenario, the participant determined whether the neonate was study eligible. One scenario required participants to submit 14 data elements to the coordinating center. Accuracy of study eligibility and data submission was summarized using standard descriptive statistics. The survey response rate was 100% (27/27). Overall accuracy in determining study eligibility was 89% (120/135), and accuracy varied across the five scenarios (range 82-93%). Overall accuracy of data submission was 92% (310/336). Data were >95% accurate for 9 of the 14 data elements, with 100% accuracy achieved for 6 data elements. These results were used to clarify eligibility criteria, inform database design, and improve training materials for the subsequent clinical trial. Health care professionals at community hospitals accurately determined trial eligibility and submitted study data based on written clinical scenarios. Research teams conducting telemedicine trials with community hospitals should consider completing pre-trial simulation activities to identify opportunities for improving trial processes and materials. Read More on PubMed

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