Examining early intervention referral patterns in neonatal intensive care unit follow up clinics using telemedicine during COVID-19.

BACKGROUND: Neonatal intensive care unit (NICU) follow up programs are in place to ensure infant health and development are monitored after discharge. The COVID-19 Public Health Epidemic (PHE) negatively impacted the ability to conduct in-person NICU follow up visits. AIMS: This study examines using telemedicine in NICU follow up clinics and compares the rates of referral for further medical and/or educational developmental evaluation. A second objective of the study examines if telemedicine can be implemented in the future to ensure access to families while maintaining high levels of caregiver satisfaction. METHOD: Data were obtained retrospectively from clinical records from one state's NICU follow-up program. Patterns of referral for further developmental evaluation and caregiver satisfaction prior to the COVID-19 PHE and during the first year of the COVID-19 PHE were examined. A total of 658 NICU follow up visits (384 in-person and 274 telemedicine) were included. RESULTS: Chi Square analyses revealed significantly more medically related referrals were made during telemedicine visits compared to in-person visits, χ2 (1) = 5.55, p .05. There were no significant differences between the clinic types in the number of educationally based referrals made, χ2 (1) = 0.028, p > .05. CONCLUSION: The rates of referral for further evaluation made from in-person and telemedicine clinics were comparable, and caregivers were highly satisfied with telemedicine clinic visits. NICU follow up via a virtual platform saves time, money and is equally effective or better in identifying the need for referral for further evaluation.

Rural mental health care during a global health pandemic: Addressing and supporting the rapid transition to tele-mental health

The adoption of tele-mental health by mental health professionals has been slow, especially in rural areas. Prior to 2020, less than half of mental health agencies offered tele-mental health for patients. In response to the global health pandemic in March of 2020, mental health therapists across the U.S. were challenged to make the rapid shift to tele-mental health to provide patient care. Given the lack of adoption of tele-mental health previously, immediate training in tele-mental health was needed. This article describes collaborative efforts between two mental health technology transfer centers and one addiction technology transfer center in rural regions of the U.S. in response to the rapid adoption of remote technologies to provide mental health services. A learning series of real-time tele-mental health trainings and supplemental materials were offered beginning in March 2020 to support this transition. A weekly learning series covered a variety of topics relevant to telehealth including technology basics, billing, state legislation, and working with children and adolescents. Given the demand of these initial training sessions, additional trainings were requested by agencies outside the regional technology transfer centers. To date, there have been more than 13,000 views of the tele-mental health web page which includes recorded training sessions, handouts, and supplemental tele-mental health materials. The article also provides a summary of the questions and concerns highlighted by the more than 4,500 providers who joined the learning series, noting key rural and urban clinical and structural barriers to providing virtual care. (PsycInfo Database Record (c) 2021 APA, all rights reserved)