185 - Evaluating the Efficacy of Telehealth vs. Home Health Nursing: A Comparative Study on Patient Outcomes and Transition Benefits.

Publication Number: 185.4699

Cassidy A. Cook, Cleveland State University, Columbia Station, OH, United States; PRABHU S. PARIMI, Metro Health Medical Center, Clevelabd, OH, United States; Jennifer E. White, MetroHealth Medical Center, Richfield, OH, United States; Debbie S. Lawson, MetroHealth Medical Center, Cleveland, OH, United States

Background: Preterm newborns ( < 32 weeks, < 1500g) often face extended hospital stays due to complications such as respiratory distress syndrome and feeding issues. Post-discharge, home health nurses assist, but their limited access to medical records can lead to fragmented care. This study evaluates whether Post-Discharge Telehealth Visits (PDTHV) by neonatal ICU nurse practitioners — with full access to patient records — improve patient outcomes, reduce ED visits, and enhance follow-up compliance compared to traditional In-Home Health Visits (IHHV).

Objective: To assess whether PDTHVs improve parent experience, reduce ED visits and readmissions, lower costs, and ensure follow-up compliance in managing preterm infants post-discharge.

Design/Methods: This comparative study included preterm infants ( < 32 weeks gestation, < 1500g) and those with congenital or chromosomal anomalies, neonatal opioid withdrawal syndrome, or other conditions identified by the Neonatology team. Late preterm infants were excluded. Infants were assigned to either PDTHV or IHHV groups. Demographics and clinical characteristics of the groups were compared using mean (SD), n (%), and Fisher’s exact test. Bar graphs displayed ED visits, hospital readmissions, and well-child care (WCC) compliance. Likert scale data were used to assess satisfaction.

Results: Of the 78 infants ( < 32 weeks gestation), 54 received IHHV and 24 received PDTHV. WCC compliance was 92.6% (IHHV) vs. 83.3% (PDTHV) (p=0.2417). Hospital readmissions were 9.3% (IHHV) vs. 8.3% (PDTHV) (p=0.6602). ED utilization was 20.8% (PDTHV) vs. 27.6% (IHHV) (p=0.4869). Satisfaction was high, with 96.4% finding telehealth easy to use and 100% reporting that questions were addressed. Despite the high satisfaction rates, the four leading concerns of telemedicine patients were noted: (1) lack of infant medication education, (2) lack of education regarding the initial MyChart sign-in, (3) lack of sufficient reminders for both telehealth visits and follow-up appointments, and (4) lack of a follow-up telemedicine call 2 weeks to 1 month post-discharge.

Conclusion(s): PDTHVs were as effective as IHHVs for managing preterm infants, improving satisfaction and compliance while being cost-effective. Areas needing improvement include education on medication, MyChart instructions, and follow-up practices. These findings suggest that PDTHV can be a viable option for post-discharge care of vulnerable neonatal populations, with minor adjustments to enhance patient education and follow-up practices.

Comparison of ED Visits and Hospital Readmissions Across Visit Types
Comparison of ED visits and hospital readmissions for PDTHV and IHHV groups, with p-values indicating no statistically significant difference between visit types.

Well-Child Care Compliance Rates by Visit Type for PDTHV and IHHV
Comparison of Well-Child Care (WCC) compliance rates between PDTHV and IHHV groups, showing no statistically significant difference.

Patient-Reported Priority Levels for Key Telehealth Concerns
Key telehealth concerns identified among patients, categorized by reported priority levels, with high priority for infant medication and MyChart education.