Creating Online Newborn Intensive Care Unit (NICU) Networks to Educate, Consult & Team

A group of organizations in southern Mississippi formed a partnership to develop, implement, and evaluate technology-based strategies to improve the coordination of care to neonates among hospitals, rural physician offices, and emergency rooms. Organizations participating in this project included the University of Southern Mississippi, Forest General Hospital (FGH), Southern Mississippi Neonatology Group, Hattiesburg Clinic, and Southeast Mississippi Rural Health Initiative. The project focused on two technology-based strategies: the development of an interoperable system for sharing electronic health information and Personal Development Health Records (PDHRs).

Three partner organizations (FGH, Southern Mississippi Neonatology Group, and Hattiesburg Clinic) with existing electronic health records (EHRs) implemented a front-end interface technology platform with their EHR systems to retrieve identified neonatal patient records from disparate clinical systems in real-time, displayed through a Web browser. In addition, PDHRs containing the medical history of treatment provided at FGH were given to caregivers of preterm infants upon discharge from the hospital in the form of a CD. Records resulting from medical appointments at Hattiesburg Clinic could also be burned onto the CD.

Hospital administrators, staff, and a physician participated in two focus groups-one designed to evaluate the interoperable system and the other designed to evaluate the PDHR. In addition, 15 caregivers who received a PDHR participated in a 15-minute telephone or face-to-face interview.

Hospital administrators and staff could easily identify the potential benefits of having an interoperable system to use when treating neonates. Despite this potential, however, most also expressed concerns ranging from the financial and legal responsibilities of maintaining such a system to the responsibilities of ensuring that patient information is consistently reported.

Although not all of the caregivers had used the PDHR, all perceived it to be an important addition to their child's health care. Of the three respondents who had taken their child to receive medical care at a facility other than the hospital, all had shared the PDHR with the physician treating their child. Hospital administrators and personnel identified similar benefits of a PDHR, although they also identified potential challenges related to the development and maintenance of a system to create the PDHR.