“Telehealth for Children: The Rural-Urban Gap” R Whit Hall MD. Director, Telemedicine Core Center for Translational Neuroscience Little Rock, Arkansas Dissertation Defense Tuesday, December 5, 12 noon Rayford Auditorium, Biomed II Bldg.

Where you live should not make a difference in whether you live or die….but it does. Rural Americans are more likely to die prematurely, and infants from rural areas are less likely to see their first birthday. The reasons are multifactorial, and include economic pressure, longer distances to receive healthcare, and unbalanced medical provider availability, especially subspecialists. Each year, neonates born in smaller, more rural nurseries are more likely to die and/or suffer neurological morbidity such as severe intraventricular hemorrhage. Telemedicine has been shown to reduce infant mortality (death before 365 days) by 1.5/1000 live births or 60 more surviving babies annually in Arkansas, primarily through enhanced regionalization of care in community nurseries. Telehealth, the use of electronic communication to improve the patient’s clinical health status, is now being used to reduce all rural-urban disparities through education, research, consultation and improved access to care. Peds PLACE, a weekly pediatric educational conference, attracts between 10 and 15 community practices weekly, and the Peds PLACE guidelines have been accessed by every continent in the world….except Antarctica. Incorporating research into the community has traditionally lagged behind academic institutions, but telemedicine is changing that through education and incorporating rural subjects in community research. Tele-consultation is now routinely occurring in a variety of specialties, especially those relying on visual cues, such as radiology and dermatology. Access to care has improved greatly due to telemedicine. There are 31 neonatologists in Arkansas, but 21 reside in Little Rock. Now, community providers from 25 nurseries in Arkansas can immediately access neonatologists on a 24/7 basis. Innovation and technology have made the development of exciting new tools such as tele-intubation to improve children’s healthcare. Making the world smaller through tele-health will make the smallest, and the most vulnerable, of our population healthier.