Megan Long MD, Presenter: Nothing to Disclose

Teresita L. Angtuaco MD, Abstract Co-Author: Nothing to Disclose

Curtis L. Lowery MD, Abstract Co-Author: Nothing to Disclose

To determine the impact of a state-wide telemedicine project on health care delivery to patients with high risk pregnancies.

The ANGELS (Antenatal and Neonatal Guidelines, Education and Learning System) project has been in existence in Arkansas since 2003. Through funding provided by a federal Medicaid contract with Arkansas Medicaid oversight ANGELS provides telemedicine equipment to rural providers at no cost. Obstetric ultrasound examinations are performed locally with portable ultrasound units. Using real-time audio/video conferencing units, weekly high-risk teleconferences are held, during which high-risk pregnancy consultation and education with interactive, real-time targeted (Level II) ultrasounds are reviewed. Suspected fetal anomalies are referred to the high-risk clinic at the University of Arkansas for Medical Sciences where a team of obstetricians, radiologists, and pediatricians evaluate the patient for further management. Feed-back and support for transfer of care is provided to the referring obstetrician. Statistical data from the past seven years of the program were analyzed to determine the impact of this telemedicine program on the overall health care delivery in the state.

ANGELS has provided 7,125 high-risk OB telemedicine consultations to women in rural Arkansas since 2003 with 2,095 telemedicine consultations and 118,527 call center consultations in 2009 alone. In the first two years of the program, ANGELS saw an increase in the proportion of low birth weight infants from rural areas delivered at UAMS from 37.7% to 42.1% and a reduction in the 60-day mortality rate by 0.5%. The services that ANGELS provides have resulted in fewer medical complications, leading to savings for the Arkansas Medicaid program estimated to be between $1.30 and $1.50 for every dollar spent on program services, a cost savings worth millions to Medicaid.

Since the inception of ANGELS in 2003 there has been enhanced access to consultations and tertiary care services for high-risk pregnant women in rural areas, reduced infant mortality, and fewer medical complications which have led to cost savings for the Arkansas Medicaid program.

The ANGELS telemedicine model has improved access to the underserved population of pregnant patients in Arkansas and improved the overall health care of women with high-risk pregnancies.

Long, M, Angtuaco, T, Lowery, C, Ultrasound in Telemedicine: Its Impact in High-Risk Obstetric Health Care Delivery.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11001853.html