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The use of mobile robotic telemedicine technology in the neonatal intensive care unit

Journal of Perinatology volume 32, pages 55–63 (2012)Cite this article

Abstract

Objective:

To describe the use of a wireless, mobile, robotic telecommunications system in the Neonatal Intensive Care Unit (NICU).

Study Design:

In this prospective study utilizing 304 patient encounters on 46 preterm and term neonates in a level IIIa NICU, a bedside neonatologist (‘on-site neonatologist’; ONSN) and a neonatologist at a distant location (‘off-site neonatologist’; OFFSN) evaluated selected demographic information, laboratory data and clinical and radiological findings of the subjects. The OFFSN used a commercial wireless, mobile, robotic telecommunications system controlled from a remote site. The two physicians were blinded to each other's findings and agreement rates of the evaluations between the ONSN and the OFFSN were compared using kappa statistics. Agreement rates between two ONSNs using the same protocol with 39 patient encounters served as the reference standard. The dependability and timeliness of data transmission were also assessed.

Result:

Excellent or intermediate-to-good agreements were noted for all but a few physical examination assessments between both the ONSN and OFFSN and the two ONSNs. Poor agreements were found for certain physical examination parameters (breath-, heart- and bowel-sounds and capillary refill time) with or without the use of telemedicine. The median duration of the encounters by the ONSN and OFFSN and the two ONSNs was similar. Five encounters were excluded from the analysis because of technical difficulties. No complications associated with the use of the mobile robot were noted.

Conclusion:

Our findings indicate that the use of mobile robotic telemedicine technology is feasible for neonates in the NICU.

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Acknowledgements

This work was supported by the UniHealth Foundation Grant (#951) and ‘The Laura P and Leland K Whittier Virtual PICU’ Junior Faculty Fellowship for Research in Telemedicine Award (SP). The authors thank Pam Costa, the data collection coordinator and Paul Vee, the technical coordinator of the study for their dedicated work. The authors also thank Drs James Gray and Randall C Wetzel for their help with the preparation of the paper. Finally, the authors would also like to acknowledge the support provided by the administration and information technology departments of Children's Hospital Los Angeles and Hollywood Presbyterian Medical Center and are indebted to the beside nurses and respiratory therapists in the NICU at Hollywood Presbyterian Medical Center for their dedicated work and contribution.

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Authors and Affiliations

  1. Center for Fetal and Neonatal Medicine and the USC Division of Neonatal Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA

    A Garingo, P Friedlich, L Tesoriero, S Patil, P Jackson & I Seri

  2. Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    A Garingo, P Friedlich, L Tesoriero, S Patil, P Jackson & I Seri

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  1. A Garingo
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  2. P Friedlich
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  3. L Tesoriero
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  4. S Patil
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Corresponding author

Correspondence to P Friedlich.

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The authors declare no conflict of interest.

Additional information

Preliminary findings of this study were presented at the PAS/SPR Annual Meeting in Baltimore, MD, USA in 2009.

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Garingo, A., Friedlich, P., Tesoriero, L. et al. The use of mobile robotic telemedicine technology in the neonatal intensive care unit. J Perinatol 32, 55–63 (2012). https://doi.org/10.1038/jp.2011.72

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