Web-based monitoring of newborns cuts ED visits, costs

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Research from Spain finds a cost benefit in applying telemedicine to monitoring low-risk newborns during their first month of life.

The researchers compared a group of infants tracked through a website called "Babies at home" and a control group who underwent usual care, which was a return visit to the hospital within 48 hours of discharge. Their work is published in the Journal of Medical Internet Research.

The "Babies at home" site had three components: a free-access area with information about baby care and breastfeeding; a parents' area, where, after authentication, they were asked to submit a questionnaire twice a week about the baby's condition. This area also allowed them to exchange email with nurses to ask questions. In the third area, physicians and nurses could see the parents' answers on the questionnaires, shown in dynamic Flash charts, and to send comments and advice directly to parents.

At the end, parents were asked to rate the usefulness of the website. Parents were positive about the easy access the website gave them to trusted baby experts.

Babies selected for the study met one of several criteria, including being born between 35 and 37 weeks, weighing from just under 5 pounds to just under 7, being firstborn and breastfeeding only, or having parents who lived more than 40 kilometers (about 25 miles) from the hospital. The baby's condition continued to be monitored until he or she reached an appropriate weight and condition.

After one month, 94.4 percent of the patients who received the Internet-based follow-up (85 of 90) had no ED visits, compared with 84.2 percent of patients in the control group (96 of 114).

The cost of the hospital-based follow-up was 182.1 euros (roughly $243.61) per patient, compared with 86.1 euros ($115) for the Internet-based follow-up. The researchers also figured incremental cost-effectiveness ratio, the cost to society, figuring in things such as parents' lost wages from missed work and other factors, finding savings of 941.2 euros ($1,255.18) for every additional infant who does not have an ED visit in the first month of life.

The American Telemedicine Association has advocated telehealth as a way to prevent pre-term labor in women with high-risk pregnancies. Based on an analysis of Medicaid costs, it has said the United States could save $186 million over 10 years through better prenatal care.

Other technological approaches to in-home baby monitoring have led to the creation of "smart pajamas" that wirelessly monitor infants' heart rate and temperature and a monitor that straps to a baby's foot that alerts parents through their smartphones if the child stops breathing or has a significant change in heart rate.

Meanwhile, more than 50,000 people have signed up for the Text4baby program, which provides educational texts for pregnant women and new mothers.

To learn more:
- read the research

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