Introduction
This issue is devoted to all our mothers and newborns.
The perinatal period is a highly vulnerable time with potential for significant mortality and morbidity to expecting mothers and their babies. Healthcare must be delivered in ways that can mitigate risks and maximize physical and mental health from the time mothers become pregnant to well beyond the time she takes her baby home. Systems that provide healthcare involves a variety of healthcare professionals practicing the “Art of Medicine”, following workflows that execute these practices, using certain tools and modalities of care delivery. These systems of care evolve over time and the speed of evolution depends on the size of the change agent. One of these agents, the recent COVID-19 pandemic, has accelerated the adoption and adaption of telemedicine as a care delivery mode in all aspects of perinatal care.
This Seminar issue, devoted to the use of telemedicine in the field of Perinatology, is organized into three main sections, mirroring a mother and her baby’s journey through the NICU experience - the prenatal period, the NICU stay and the transition period from discharge to home. The sections are bookended by a historical review of telemedicine use in neonatology and later, two chapters on implementation and evaluation strategies. The collective experiences of contributing authors to this issue are invaluable, pioneering and greatly appreciated.
Paul Batalden famously said, “Every system is perfectly designed to get the results that it gets.” Therefore, a health care delivery system designed originally without telemedicine should be redesigned in ways that can ensure the safe and effective use of such tools. While returning practices to “pre-pandemic business as usual” would be a mistake, we must use telemedicine with caution. We encourage readers to consider how telemedicine can be leveraged in their own practices while monitoring and mitigating the risks discussed in the following chapters. As perinatal practices and centers evolve, we must continue to collaborate with each other and other stakeholders to create a learning environment that will cultivate perinatal care systems that are capable of optimizing the health of all mothers and babies.
Acknowledgments
This work is supported, in part, through the SPROUT-CTSA Collaborative Telehealth Research Network and funded in part by National Institutes of Health (NIH) National Center for Advancing Translational Science (NCATS) – Grant #U01TR002626. We would like to thank the Children’s Hospital Neonatal Consortium, Digital Health Focus Group, and the American Academy of Pediatrics, Section on Telehealth Care, SPROUT Research Group for providing the critical forums and structure for collaboration in this important work.
Footnotes
Declaration of Competing Interest
None.