Several programs are providing better access to care and improving the outcomes for high-risk pregnancies in rural areas. The Antenatal & Neonatal Guidelines, Education, and Learning System (ANGELS), a successful program in Arkansas, links clinicians and patients across the state with the University of Arkansas for Medical Sciences. Telehealth consultations are provided with patients, their local physicians, and UAMS specialists using interactive teleconferencing.
UAMS provides virtually all of the state’s high risk pregnancy services, maternal-fetal medicine specialists, and prenatal genetic counselors. UAMS has the only board-certified maternal fetal medicine unit in the state and employs three maternal-fetal medicine specialists handling 2,300 births each year in their 12 bed labor and delivery unit. In addition, there is a 30 bed neonatal unit with an additional 70 neonatal beds at Arkansas Children’s Hospital.
UAMS telemedicine consultations have increased from less than 50 in 2000 to 1,270 in 2007. The Center receives more than 2,000 calls per month. In addition, ANGELS has fully equipped 20 rural sites with telemedicine technology plus an additional 20 sites with teleconferencing equipment.
So far, ANGELS has increased the proportion of low birth weight infants delivered at UAMS from 37.7 percent to 42.1 percent which means the 60 day infant mortality rate was reduced by 0.5 percent.
Since 2005, 1,244 high-risk women in need of tertiary care have been transferred to UAMS and would not have been if the program weren’t available. The likelihood of a Medicaid beneficiary being able to deliver a premature or low birth weight infant at UAMS has increased by 42 percent since the program began.
In addressing ROI, the consultations and more specialized care has resulted in fewer medical complications leading to savings for the Arkansas Medicaid program. Estimates are that ANGELS has generated a cost savings for the Medicaid program of between $1.30 and $1.50 for every dollar spent on program services.
In another program in Tennessee as reported by (chattanoogan.com), the Community Health Network and Regional Obstetrical Consultants are working together on a video medical network project funded with a $1.8 million grant from BlueCross BlueShield of Tennessee Health Foundation.
The program helps pregnant mothers and their babies in the rural areas of East Tennessee by linking three centers. Small town doctors who are now treating pregnant women will be able to consult electronically with obstetric specialists in Knoxville and Chattanooga when there are serious problems.
The program will be connected to the Community Health Network’s existing network for telemedicine and to other telehealth applications that stretch across the state. Obstetrical patients at any of the CHN Telehealth Network’s 55 existing sites or any of the eleven new perinatal sites will be able to consult in real-time with a remote perinatologist by scheduling a telemedicine visit in their local community. Within the next 12 to 18 months, nine other areas will be added according to Dr. David Adair, CEO, Regional Obstetrical Consultants clinics in Tullahoma and Newport.