186 - Using Telemedicine in Neonatology: A Model for Reducing Health Care Utilization Post Discharge in Preterm Infants

Publication Number: 4183.186

Maitri Shah, Cleveland Clinic Children's, cleveland, OH, United States; Sarah Khreizat, Michigan State University College of Human Medicine, East Lansing, MI, United States; Alyson N. Brown, Cleveland Clinic Children's, Cleveland Heights, OH, United States; Erin Sweigart, Cleveland Clinic Children's, Cleveland, OH, United States; Amanda Smith, Cleveland Clinic Children's, Medina, OH, United States; HANY ALY, Cleveland Clinic Children's Hospital, Cleveland, OH, United States; Ajith Mathew, Cleveland Clinic Children's, Cleveland, OH, United States; Anirudha Das, Cleveland Clinic Children's, Lakewood, OH, United States; Emman Dabaja, Cleveland Clinic Children's, Cleveland, OH, United States

Background: Preterm infants born less than 32 weeks are particularly at high risk for hospital readmissions, emergency visits, and poor neurodevelopmental outcomes following prolonged NICU stays. National data indicates that 3–8% of infants are readmitted within 30 days of discharge, as families transition home. Telemedicine serves as a novel medium to maintain continuity of care for complex neonatal patients post discharge and reduce subsequent healthcare utilization.

Objective: All patients discharged from our institution’s 6 NICUs are scheduled for a telehealth visit within 1 week of discharge, to help mitigate potential healthcare utilization and ensure continuity of care. Our objective was to evaluate how adherence to a NICU telehealth clinic appointment associates with further ED visits and hospital readmissions within one month of discharge and subsequent neurodevelopmental follow up visit adherence.

Design/Methods: This retrospective study included 145 infants (selected via computer-based randomization) from a subset of 1366 patients admitted from 2019 to 2025. Inclusion criteria included infants born ≤32 weeks gestation admitted to Level III NICUs in our institution. Data from electronic medical records included neonatal, maternal, and socioeconomic variables. Primary outcomes included attendance at NICU telehealth clinic post discharge, attendance at neurodevelopmental clinics over a two-year period, hospital readmissions and ED visits within one month of discharge.

Results: Of all patients included in the study, none had ED visits, hospital readmissions, or ICU admissions within 1 month post discharge. Attendance at our NICU telehealth clinic was associated with fewer subsequent hospital readmissions and emergency department visits among this vulnerable patient population. Among patients who attended NICU telehealth clinic, more than half (56%) attended at least the first two scheduled visits at the neurodevelopmental clinic.

Conclusion(s): Attendance of the NICU telehealth appointment post discharge was associated with reduced healthcare utilization among preterm infants born ≤32 weeks and increased adherence to neurodevelopmental follow up clinic.