{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T11:32:24Z","timestamp":1782905544795,"version":"3.54.5"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"01","funder":[{"name":"National Institutes of Health for the Center of Biomedical Research Excellence in Acute Care Research and Rural Disparities","award":["1P20GM139745-01"],"award-info":[{"award-number":["1P20GM139745-01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We aimed to determine if the implementation of teleconsults in the community hospital would decrease the time to initiation of therapeutic hypothermia (TH).<\/jats:p>\n                  <jats:p>We compared neonates treated with TH prior to implementation of the teleconsult program (pretele) to those treated after (posttele) for the outcomes of time to initiation of TH, seizures, and death\/severe injury on brain MRI. We controlled for confounders using multivariable linear and logistic regression models.<\/jats:p>\n                  <jats:p>There were 52 pretele neonates and 49 posttele who were all born in community hospitals and treated with TH. Mothers in the posttele group were older and had higher rates of gestational diabetes. Fewer neonates with mild encephalopathy were cooled in the posttele period (13 [25.0%] pretele vs. 2 [4.1%] posttele). After controlling for gestational diabetes, maternal age, and severity of encephalopathy, there was no difference in time to TH initiation (p\u2009=\u20090.445), brain injury or death (p\u2009=\u20090.136), or seizure (p\u2009=\u20090.433) between the pre-and posttele groups. In the sub-analysis of the posttele group, the time to initiation was 4.50\u2009hours (3.75, 5.00) for those with teleconsults versus 3.25 (2.12, 4.00) hours (p\u2009=\u20090.007) for those without.<\/jats:p>\n                  <jats:p>When comparing pre- to posttele groups, teleconsults in the community hospital did not significantly change the time to initiate TH or result in more adverse short-term outcomes of seizures or death\/brain injury. In the sub-analysis of the posttele group, teleconsults did result in delayed initiation of TH but also possibly improved patient selection with fewer mildly encephalopathic neonates treated.<\/jats:p>","DOI":"10.1055\/a-2541-3763","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T18:59:21Z","timestamp":1739991561000},"page":"131-135","source":"Crossref","is-referenced-by-count":3,"title":["Telemedicine Consultations in Community Hospitals Improve Neonatal Encephalopathy Assessment"],"prefix":"10.1055","volume":"43","author":[{"given":"Anya","family":"Cutler","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Population and Health Research, MaineHealth, Westbrook, Maine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah Marie","family":"Seften","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, Maine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6477-3390","authenticated-orcid":false,"given":"Alexa","family":"Craig","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Tufts University School of Medicine, Boston, Massachusetts"},{"name":"Division of Pediatric Neurology, Department of Pediatrics, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, Maine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,3,29]]},"reference":[{"issue":"01","key":"ref1","first-page":"CD003311","article-title":"Cooling for newborns with hypoxic ischaemic encephalopathy","volume":"2013","author":"S E Jacobs","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1038\/s41390-019-0291-1","article-title":"Should therapeutic hypothermia be offered to babies with mild neonatal encephalopathy in the first 6\u2009h after birth?","volume":"85","author":"M El-Dib","year":"2019","journal-title":"Pediatr Res"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.earlhumdev.2018.02.008","article-title":"A review of the conundrum of mild hypoxic-ischemic encephalopathy: Current challenges and moving forward","volume":"120","author":"L Chalak","year":"2018","journal-title":"Early Hum Dev"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"449","DOI":"10.3233\/NPM-190368","article-title":"Neonates with hypoxic-ischemic encephalopathy treated with hypothermia: observations in a large Canadian population and determinants of death and\/or brain injury","volume":"13","author":"E H Xu","year":"2020","journal-title":"J Neonatal Perinatal Med"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1159\/000353948","article-title":"Time is brain: starting therapeutic hypothermia within three hours after birth improves motor outcome in asphyxiated newborns","volume":"104","author":"M Thoresen","year":"2013","journal-title":"Neonatology"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1111\/jrh.12820","article-title":"Effects of rurality and distance to care on perinatal outcomes over a 1-year period during the COVID-19 pandemic","volume":"40","author":"P V Bujimalla","year":"2024","journal-title":"J Rural Health"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1038\/s41372-020-00828-3","article-title":"Telemedicine consults to assess neonatal encephalopathy are feasible in the neonatal intensive care unit","volume":"41","author":"A K Craig","year":"2021","journal-title":"J Perinatol"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1038\/jp.2013.159","article-title":"Telemedicine for genetic and neurologic evaluation in the neonatal intensive care unit","volume":"34","author":"T L Wenger","year":"2014","journal-title":"J Perinatol"},{"issue":"12","key":"ref9","doi-asserted-by":"crossref","first-page":"1990","DOI":"10.1377\/hlthaff.2018.05133","article-title":"The effect of a newborn telehealth program on transfers avoided: a multiple-baseline study","volume":"37","author":"J Albritton","year":"2018","journal-title":"Health Aff (Millwood)"},{"issue":"04","key":"ref10","first-page":"50","article-title":"Use of telemedicine to improve neonatal resuscitation","volume":"6","author":"L T Donohue","year":"2019","journal-title":"Children (Basel)"},{"issue":"12","key":"ref11","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1016\/j.mayocp.2016.08.006","article-title":"Emergency video telemedicine consultation for newborn resuscitations: the Mayo Clinic experience","volume":"91","author":"J L Fang","year":"2016","journal-title":"Mayo Clin 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Pediatr"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.pediatrneurol.2024.07.013","article-title":"Clinician stakeholder experience with telemedicine consults to assess neonatal encephalopathy in a rural state","volume":"160","author":"L M Seften","year":"2024","journal-title":"Pediatr Neurol"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1055\/a-2421-8486","article-title":"Development and evaluation of a rural longitudinal neonatal resuscitation program telesimulation program (moose: Maine ongoing outreach simulation education)","author":"M Melendi","year":"2024","journal-title":"Am J Perinatol"},{"issue":"11","key":"ref18","doi-asserted-by":"crossref","first-page":"e2343429","DOI":"10.1001\/jamanetworkopen.2023.43429","article-title":"Remote monitoring for seizures during therapeutic hypothermia in neonates with hypoxic-ischemic encephalopathy","volume":"6","author":"G FT Variane","year":"2023","journal-title":"JAMA Netw 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