Use Of Telemedicine Research Articles

Use of telemedicine for trauma care since the Russian invasion of Ukraine: A qualitative assessment.

Ukraine's health and trauma system has been detrimentally impacted since the start of the Russian invasion in February 2022. Use of telemedicine became critical to providing timely medical care. As such, the aim of this study was to describe telemedicine's use in the health and trauma system of Ukraine following the full-scale invasion. We conducted qualitative key informant interviews with military and civilian health care workers using an expanded version of the Global Trauma System Evaluation Tool which had components focusing on telemedicine use. Thematic content analysis was used to derive key telemedicine themes from interviews. We conducted 36 key informant interviews. Most respondents described using telemedicine through informal means of communication such as messaging apps to meet patient care needs. Concerns and challenges with use of telemedicine included weapons targeting, internet connections and safety of communications from Russian hackers. A unified system for telemedicine would greatly improve use in country both during and post conflict. Telemedicine use has rapidly increased in Ukraine during the current conflict particularly in the scope of providing trauma care when numerous specialties are needed. Development of a unified, secure telemedicine system with mechanisms for integrating multinational medical support would aid in providing swift medical care to persons injured in the conflict or unable to access a specialty provider in their proximity.

Interprofessional team training via telemedicine in medical and nursing education.

The use of information communication technologies such as telemedicine has increased over the years, offering access to specialized healthcare even in remote locations. However, telemedicine in interprofessional team training is seldom included in medical or nursing programs, and little is known about how to practise these scenarios. This study aimed to explore how medical and nursing students experience teamwork when one team member is participating remotely and digitally. Following interprofessional team training in which one team member participated remotely, focus group interviews were conducted with three teams, each comprising one medical student and two nursing students (n = 9 students in total). The focus group interviews were analysed with thematic content analysis. The Systems Engineering Initiative for Patient Safety model was applied as a theoretical framework and served as a lens in the analysis. Three themes were identified in the analysis: challenging the dynamic of leadership, becoming familiar with a new setting, and finding new strategies to communicate. The results of this study suggest that future physicians and nurses need to enhance their knowledge of practicing teamwork through telemedicine during their education, as the use of telemedicine continues to grow.

Vision impairment and blindness in individuals aged 60 years and older in Latin America and the Caribbean.

To determine the prevalence and causes of vision loss and calculate the effective cataract surgery coverage (eCSC) in adults aged 60 years and older in Latin America and the Caribbean in 2020. The International Agency for the Prevention of Blindness Vision Atlas and the Rapid Assessment of Avoidable Blindness databases were used as data source. The collected data were used to estimate the prevalence and causes of vision loss in people aged 60 years and older, and to determine the eCSC. The overall prevalence of moderate to severe vision impairment (MSVI) and blindness in Latin America and the Caribbean were 14.14% and 2.94%, respectively. Tropical Latin America was the subregion with the highest prevalence of blindness (3.89%) while Southern Latin America had the lowest (0.96%). For both MSVI and blindness, cataract was the main cause of vision loss. The eCSC rates showed great variation, ranging from 4.0% in Guatemala to 75.2% in Suriname. The prevalence of vision loss in adults aged 60 years and older in Latin America and the Caribbean was higher than previous estimates on younger groups. Cataract was the main cause of blindness, and the eCSC indicates that the outcomes from cataract surgery should be improved. Specific actions associated with improving access, integrating eye assessment with primary care programs, expanding the use of telemedicine, and improving data quality should be taken by public health authorities aiming to address vision loss in this group.

Association between telehealth use in oncology and downstream utilization at a large academic health system.

While telemedicine has been beneficial in oncology by reducing infectious exposure and improving access for patients with poor functional status, it also has intrinsic limitations, including the inability to perform a physical exam, which could lead to increased downstream utilization in this population at high risk of medical decompensation. We conducted a retrospective cohort study investigating the relationship between telemedicine use in oncology and subsequent outpatient oncology encounters, emergency department (ED) visits, and hospitalizations. We included outpatient oncology encounters, including telemedicine and in-person visits, occurring between 1 January 2018 and 31 December 2022 at a large academic health system. Unadjusted descriptive statistics and multiple linear regressions were used to estimate subsequent outpatient oncology visits, ED visits, and hospitalizations within 30 days of an index visit based on modality (telemedicine versus in-person). The multiple regressions were adjusted for various demographic and clinical characteristics, including palliative care visits, baseline utilization, recent chemotherapy, and comorbidities. Our cohort included 63,722 patients with 689,356 outpatient encounters, of which 639,217 (92.7%) were in-person and 50,139 (7.3%) were telemedicine visits. Patients on average had 0.91 outpatient oncology visits, 0.04 ED visits, and 0.05 hospitalizations within 30 days following an index encounter. In our adjusted analyses, telemedicine was associated with 13.7 fewer downstream outpatient oncology visits (95% CI 12.5-14.9; p < 0.001) per 100 index encounters, 0.7 fewer ED visits (95% CI 0.4-1.0; p < 0.001) per 100 index encounters and 0.9 fewer hospitalizations (95% CI 0.6-1.3; p < 0.001) per 100 index encounters compared to in-person visits. Contrary to our hypothesis, oncology patients who had a telemedicine visit had fewer follow-up outpatient oncology encounters, ED visits and hospitalizations after 30 days than those with in-person visits. Future studies should further investigate the efficacy of telemedicine in oncology and outline specific scenarios for appropriate use in this and other populations.

Opportunities for the use of telemedicine in home hospice care: lessons learned from the COVID-19 pandemic

Opportunities for the use of telemedicine in home hospice care: lessons learned from the COVID-19 pandemic

8378 Disparities In Telemedicine Use In Latinx Patients With Diabetes: Real Life Observations

Abstract Disclosure: S. Kim: Consulting Fee; Self; Signos, Inc.. Grant Recipient; Self; The Diabetes Link. P. Thedki: None. L.A. Wright: None. Background and Aims The Latinx population is disproportionately affected by diabetes and related complications and face greater challenges to accessing medical care than white patients. Telemedicine, a novel strategy for addressing such lack of access has not been evaluated in the Latinx population affected by diabetes.We aimed to assess telemedicine use in Latinx patients with diabetes compared to non-Latinx, within the same diabetes clinic (same care team and access to same digital platform). Secondary aims: HbA1c and use of CGM. Methods: All patients were offered telemedicine services and were considered users if they completed =/&amp;gt;1 telemedicine visit during the 3-month study period. Demographics, race/ethnicity, telemedicine use, language, type of diabetes: type 1(T1D), type 2(T2D) or other; HbA1c(+/- 3 months from visit) and use of CGM at the time of visit were extracted. Results: Latinx patients: n=61, 42 Spanish speaking only; mean age 52.4; 32 female; 46 with T2D. Non-Latinx: n=81, mean age 53.2; 43 female; 43 had T1D. Telemedicine use was 22% in Latinx vs 39% in non-Latinx patients, p=0.007. Mean A1c was 7.4% in Latinx vs 7.1% in non-Latinx, p=0.04 CGM use was more common in non-Latinx patients, p=0.01. Conclusions T2D was more common and telemedicine use was lower in Latinx compared to non-Latinx patients, most were Spanish speaking only, they had higher HbA1c and less CGM use. While telemedicine has the potential to increase access to care, social determinants of health, such as digital literacy, access to device and/or reliable internet are likely barriers that contribute to health inequalities in this population. Presentation: 6/2/2024

Innovative Approaches to Strengthening Preventative Care in Contemporary Healthcare: A Systematic Review

Preventative care plays a critical role in reducing disease burden, improving patient outcomes, and lowering healthcare costs in contemporary medicine. However, the effective implementation of preventative care strategies faces numerous challenges, including technological, financial, and social barriers. This systematic review explores innovative approaches aimed at strengthening preventative care in modern healthcare systems. Key innovations include the use of telemedicine, artificial intelligence (AI), personalized medicine, and community-based public health initiatives. Telemedicine and AI have revolutionized early detection and risk assessment, while personalized medicine and genomic screening allow for tailored preventative interventions. Additionally, behavioral economics and health education programs have proven effective in promoting healthier lifestyles and improving adherence to preventative measures. The review evaluates the impact of these innovations on patient outcomes and highlights both the benefits and challenges of implementing these approaches. While the advancements offer promising results, further research is needed to address issues related to equity, ethical concerns, and global applicability. This review provides valuable insights for healthcare providers, policymakers, and researchers looking to enhance the effectiveness of preventative care strategies in contemporary healthcare systems.

Delivering Culturally Competent Care to Migrants by Healthcare Personnel: A Crucial Aspect of Delivering Culturally Sensitive Care

The increasing cultural and ethnic diversity within global migrant populations necessitates the provision of culturally competent care by healthcare personnel. This narrative literature review critically analyzes existing literature on the delivery of culturally competent care to migrants, highlighting key theoretical frameworks, empirical findings, and practical strategies to enhance cultural competence in healthcare settings. The review identifies significant health disparities faced by migrants, including barriers to accessing healthcare, communication challenges, and systemic issues within healthcare institutions. It emphasizes the importance of comprehensive training programs, supportive organizational policies, community engagement, and the innovative use of technology and telemedicine. Furthermore, it addresses the future directions and research gaps, calling for longitudinal studies, the development of robust metrics, and targeted strategies to overcome the digital divide and ensure data privacy. By addressing these areas, healthcare providers, educators, and policymakers can improve healthcare delivery, reduce health disparities, and ensure equitable access to care for migrant populations.

Comparison of Telemedicine Usage at Two Distinct Medicaid-Focused Pediatric Clinics.

Objective: To compare telemedicine versus office visit use at two Medicaid-focused pediatric primary care clinics. Methods: Retrospective cohort study from March 15, 2020 - March 15, 2021 at two Medicaid-focused pediatric primary care clinics. Site A and Site B care for different populations (Site B care for mostly immigrant families with preferred language Spanish). Outcomes included the percent of visits conducted through telemedicine and reason for visit. Descriptive statistics, univariable and multivariable mixed multilevel logistic regression, were used to assess relationship between patient demographics and telemedicine use. Results: Out of 17,142 total visits, 13% of encounters at Site A (n = 987) and 25% of encounters at Site B (n = 2,421) were conducted using telemedicine. Around 13.8% of well-child care (n = 1,515/10,997), 36.2% of mental health care (n = 572/1,581), and 25.0% of acute care/follow-up (n = 1,893/7,562) were telemedicine visits. After adjustment for covariates, there was no difference in odds of a patient having any telemedicine use by preferred language, sex, or payor. Patients 1-4 years of age had the lowest odds of telemedicine use. At Site A, patients who identified as Non-Hispanic Black (odds ratio [OR] = 0.33, 95% confidence interval [CI] = 0.24-0.45), Hispanic/Latinx (OR = 0.40, 95% CI = 0.24-0.66), or other race/ethnicity (OR = 0.35, 95% CI = 0.23-0.55) had lower odds of telemedicine use in comparison to Non-Hispanic White. Conclusions: Telemedicine was successfully accessed by Medicaid enrollees for different types of pediatric primary care. There was no difference in telemedicine use by preferred language and payor. However, differences existed by age at both sites and by race/ethnicity at one site. Future research should explore operational factors that improve telemedicine access for marginalized groups.

Healthcare Disparities in Telemedicine Access and Use During the COVID‐19 Pandemic

ABSTRACTThis study investigates disparities in telemedicine access and use among racial groups in the United States during the COVID‐19 pandemic. Our analysis of a dataset from the National Center for Health Statistics (NCHS) reveals that telemedicine access and use varied significantly across racial groups, which the NCHS categorized as “Black,” “Hispanic,” “White,” or “Other.” Hispanic respondents were more likely to lack a regular place of care, which might explain their lower access to telemedicine, relative to other groups. White respondents reported relatively high telemedicine access. Black respondents also reported relatively high rates of telemedicine use, contrary to the literature suggesting lower healthcare access among African Americans. Findings underscore the need for public health agencies to disseminate information about telemedicine to all community members. We suggest future research exploring the socioeconomic barriers impacting individuals' ability to access and use telemedicine.

Uptake of and factors associated with telemedicine use for palliative care among patients diagnosed with advanced cancers during the onset of COVID-19.

53 Background: The COVID-19 pandemic propelled a rapid shift to telemedicine use, including patients with advanced cancers needing palliative care (PC). Yet, little is known about disparities in telemedicine use for PC. We leveraged population-based data to examine the trend and factors associated with telemedicine use for PC among Medicare beneficiaries diagnosed with advanced cancers during the onset of COVID-19 pandemic. Methods: We identified patients aged ≥65.5 years diagnosed with advanced-stage breast, colorectal, non-small cell lung (NSCL), small cell lung (SCL), pancreas, and prostate cancers in 2015-2019 from the SEER-Medicare data. We included those with continuous fee-for-service coverage and had any PC claims from diagnosis to death, hospice admission, or by 12/31/2020 (whichever came first). Telemedicine was identified using procedure codes, modifiers, and place of service codes on PC claims. We described the percent of PC recipients using telemedicine each quarter in 2019-2020. Multivariable logistic models assessed patient and provider characteristics associated with telemedicine use among PC recipients in 2020. Results: Telemedicine use for PC was 0.24% to 0.48% across 4 quarters in 2019, which increased to 16.3% in Q1 and stabilized at about 30% in Q2-Q4 in 2020. Among 2,945 PC recipients in 2020, 22.5% used telemedicine. Older patients (75-84 years and 85+ years) were 4.4 percentage points (ppts) and 8.6 ppts (p-values&lt;0.05) less likely than patients ages 65-74 years to use telemedicine. Patients who were female (4.4 ppts), residing in higher socioeconomic status areas (Yost Quintile 5 vs 1: 7.7 ppts), treated by female providers (4.1 ppts), in hospital system (3.7 ppts vs. individual physician office) and organizations with hospice and palliative care specialists (8.9 ppts) were more likely to use telemedicine for PC (all p-values&lt;0.05). (Table). Conclusions: Telemedicine use for PC surged during the onset of the COVID-19 pandemic, with considerable disparities by patient sociodemographic and provider characteristics. These disparities suggest potential barriers related to patients’ technology literacy and internet access, provider awareness, and healthcare organization resources. Future mixed-method studies need to elucidate these barriers to design interventions at patient, provider, and system levels to ensure effective PC delivery. Selected factors associated with telemedicine use for palliative care. Absolute Probability Difference (95%CI) Age group (ref: 65-74) 75-84 -4.4 (-7.6, -1.2) 85+ -8.6 (-13.4, -3.7) Female (ref: Male) 4.4 (0.9, 7.9) Yost quintile (ref : Q1-Q2) Q3-Q4 2.2 (-1.7, 6.1) Q5 7.7 (3.3, 12.1) Hospital system (ref: Individual physician office) 3.7 (0.6, 6.7) Provider: Female (ref: Male) 4.1 (0.7, 7.5) Organization with hospice and palliative care specialists 8.9 (5.4, 12.4)

Telemedicine in geriatric oncology is here to stay.

Advancing age is the most important risk factor for cancer. Collaborations with medical and surgical-oncology divisions, and supportive services are required to assist older adults with cancer through their assessment and treatment trajectories. This often requires numerous clinical encounters which can increase treatment burden on the patient and caregivers. One solution that may lighten this load is the use of telemedicine. At Memorial Sloan Kettering, the Cancer and Aging Interdisciplinary Team (CAIT) clinic risk stratifies and optimizes older adults planned for medical cancer treatment. We analyzed patients seen in the CAIT clinic between May 2021 and December 2023, focusing on their utilization of telemedicine, and on the differences in characteristics of the visits and the results of the Geriatric Assessment based on visit type. Of the 288 patients (age range 67-100) evaluated, the majority (77%) chose telemedicine visits. Older age, lower educational status, living in New York City, abnormal cognitive screen, impaired performance measures, IADL dependency and having poor social support were all associated with choosing an in-person visit as opposed to telemedicine. Older patients with cancer frequently choose and can complete telemedicine visits. Efforts should be directed to develop an infrastructure for remote engagement, improving reach into rural and underserved areas, decreasing the burden generated by multiple appointments.

Use of Telemedicine in a Sports Medicine Clinic: An Investigation of Patient Satisfaction

Objective: Compare patient satisfaction between telemedicine and in-office visits and between providers post-operatively in an orthopedics setting with athletic trainers and physicians. Design: Cross-sectional study Methods: Patients from a Sports Medicine Clinic that received an orthopedic surgical intervention from March 2020-September 2021, and engaged in telemedicine, or an in-office visit post-operatively. Provider type included full-time athletic trainers, resident athletic trainers, physician (MD) resident/fellows, and float athletic trainers. Press-Ganey Patient Experience Surveys were collected at the time of follow up visit, with focus on items, “likelihood to recommend” and “how well staff worked together.” Results: There was a total of 255 patients (age=50±17 years). Providers included the attending physician with full-time athletic trainers (n=134, 52.3%), resident athletic trainers (n=77, 30.1%), MD residents/fellows (n=38, 14.8%), or float athletic trainers (n=6, 2.3%). No significant difference was found with patient satisfaction between in-office (n=175, 68.4%), or telemedicine visits (n=80, 31.3%), (p&gt;.44). Patients were more satisfied with care provided by the full-time athletic trainers compared to MD residents/fellows (p.18). Conclusions: This study demonstrates no significant differences with patient satisfaction between in-office or telemedicine visits. Patients seeing full-time athletic trainers had the highest patient satisfaction, demonstrating the capability of athletic trainers to effectively use telemedicine in a physician practice.

Can tele-physiotherapy help in filling treatment gaps during pandemics in multiple sclerosis?

ABSTRACT Background: Published data demonstrate promising results for rehabilitation in patients with multiple sclerosis (MS), including telerehabilitation technologies. Given the travel limitations during the coronavirus disease 2019 (COVID-19), telerehabilitation may provide a viable alternative to in-person physiotherapy. Objective: To determine the efficacy of telerehabilitation in MS patients during COVID-19. Design/Methods: A total of 42 patients participated in the study of which 24 were followed up till the end of 6 weeks. The investigated group consisted of 15 females and 09 males; the mean age was 42 ± 10 years. The telerehabilitation was provided for a duration of 6 weeks at a frequency of three classes per week. The patients used either laptops or mobile phones for attending these sessions. The inclusion criteria were a 6-minute walk test (with or without assistance). Motor function was evaluated using the Timed Up and Go (TUG) test and the 30-Second Sit-to-Stand (30STS) test. Patients were required to fill out two questionnaires also: 12-item MS Walking Scale (MSWS) and Modified Fatigue Impact Scale (MFIS). All the patient assessments were made by an independent physiotherapist before and after the intervention. Results: There was a statistically significant improvement in motor performance and MFIS and 12-item MSWS. The following results were observed: statistically improved parameters of TUG, 30STS, 12-item MSWS and MFIS. Conclusions: Based on the findings, it is reasonable to infer that the use of telemedicine in the rehabilitation of MS patients is very promising.

8748 Use of Telemedicine In Diabetes Self-Management Education (DSME) Of Patients With Type 2 Diabetes Mellitus At The University of Santo Tomas Hospital: A Randomized Controlled Trial

8748 Use of Telemedicine In Diabetes Self-Management Education (DSME) Of Patients With Type 2 Diabetes Mellitus At The University of Santo Tomas Hospital: A Randomized Controlled Trial

Downstream Emergency Department and Hospital Utilization Comparably Low Following In-Person Versus Telemedicine Primary Care for High-Risk Conditions.

Telemedicine use expanded greatly during the COVID-19 pandemic. More data is needed to understand how this shift may impact other venues of acute care delivery. We evaluate the association of visit modality (telephone, video, or office) and downstream emergency department (ED) and hospital visits among primary care visits for acute, time-sensitive conditions. Observational study of patient-scheduled primary care telemedicine and office visits for acute conditions (cardiac, gastrointestinal, neurologic, musculoskeletal, and head and neck) in a large, integrated healthcare delivery system. Adults with a new self-booked primary care appointment for an eligible acute condition from January 1, 2022, to December 31, 2022 (with no primary care, ED, or hospital visits in prior 30 days). Visit modality, including office, video, or telephone. Seven-day ED and hospital utilization, adjusted for patient and visit characteristics. Among 258,958 primary care visits by 239,240 adult patients, 57.7% were telemedicine visits; of these, 72.4% were telephone and 27.6% were video. Telephone visits were the timeliest, with over 70% of visits scheduled within 1 day of booking. Rates of 7-day ED utilization were low, and varied by condition group, with cardiac visits having the highest rates (4.8%) and musculoskeletal visits having the lowest (0.8%). There was less than a 1% absolute difference in ED use by visit modality for all condition types; however, telephone visits were associated with slightly higher rates than video visits. The 7-day hospitalization rate was less than 1% and observed between visit type differences varied by clinical condition. Among office, telephone, and video visits in primary care for potentially high-risk, time-sensitive conditions, downstream ED and hospital use were uncommon. ED utilization was lower for video visits than telephone visits, although telephone visits were timelier and may offer a safe and accessible option for acute care.

Nursing care aspects and indicators impacted by information and communication technology: Systematic review

Background: Information technology is used in healthcare to solve the problems of an aging population, an increase in chronic illnesses, and the growing need for autonomy, independence, and quality of life. The adoption rate of IT applications among professionals such as nurses is relatively low, and it appears that not using them is the norm. Finding nursing care aspects and indications that have been altered by IT was our goal in doing this research. Method: The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement (9) was adhered to in this systematic review. Our search objective was to locate papers that addressed nursing care aspects and indicators that were changed by IT. The search method was used in the Google Scholar, CINAHL, and PubMed databases between 2015 and 2023. Result: Five publications were included in this systematic review. Four studies found elements related to teams that affect the adoption of telemedicine. The organizational and team culture is one of the main determinants of technology adoption. One study found that creative companies support employees in adjusting to new circumstances and that telemedicine implementation requires cultural transformation in enterprises. Implementing telemedicine in a company can be hindered by working in a changing environment and resisting change. Employees felt overwhelmed by all of the changes they experienced at work. Workloads increased as other advances were sometimes considered more significant than the use of telemedicine. Conclusion: When technology is used improperly, nurses can get disillusioned with its use for tasks that are traditionally completed by humans. Therefore, if healthcare professionals want to include telemedicine into their regular workflow, they must remove hurdles.

A single-center experience in home management of mild and moderate COVID-19 cases.

The use of telemedicine for treatment of coronavirus disease 2019 (COVID-19) infection has been effective in lowering the risk of infection and relieving strain on the healthcare system. This study aimed to describe the clinical characteristics of COVID-19 cases, their follow-up, risk factors of disease severity, and predictors of hospital admission while using telemedicine. The study included 611 Egyptian patients with mild and moderate COVID-19 disease. The patients were isolated at home and monitored daily. Based on the World Health Organization classification, 79% of studied patients had mild illness while 20.5% had moderate illness. The initial symptoms included cough (51.7%), fever (50.8%), fatigue (45.9%), sore throat (41.1%), dyspnea (35.2%), and headache (34%); 25.2% patients had prolonged symptoms (≥ 21 days). Dyspnea was the most frequent (15.5%) long-term symptom. Age, co-existing diabetes, and COVID-19 infection with moderate severity, were associated with the need for hospitalization. We compared patients with COVID-19 infection who required hospital admission (n = 37) versus patients who continued in home isolation (n = 574). High neutrophil/lymphocyte ratio, transaminases, and ferritin significantly correlated with the need for hospitalization. 18.9% of the patients who required hospital admission had diabetes. Multivariate analysis described age and diabetes as independent predictors of disease severity. Age and high neutrophil/lymphocyte ratio were independent predictors of hospital admission. Telemedicine is effective in-home management of mild/moderate COVID-19 patients, which may ease the pressure on the healthcare system, even beyond the pandemic.

The Benefits and Challenges of Implementing Teleophthalmology in Low-Resource Settings: A Systematic Review.

Technology has significantly changed medical practice, including diagnosis, treatment, and availability. Telemedicine use in the specialty of ophthalmology seems to be a promising field. In underserved populations, limited coverage of ophthalmic healthcare facilities results in a higher burden of eye-related diseases and visual impairment. The main obstacle preventing these individuals from receiving eye care consultations is difficulty in access and transportation. There is an urgent need for eye care facilities for these people, and teleophthalmology has the potential to provide eye care facilities to these underserved people. Teleophthalmology was reported as cost-effective, time-saving, reliable, and efficient for underserved populations. However, teleophthalmology has certain limitations in its implementation in the form of a high initial cost of equipment, problems with consistent electricity and internet supply, and the reluctance of people in certain regions toward acceptance of teleophthalmology. This systematic review assessed the benefits and challenges of implementing teleophthalmology in low-resource settings.

Teleneonatal or routine resuscitation in extremely preterm infants: a randomized simulation trial.

Teleneonatology, the use of telemedicine for newborn resuscitation and care, can connect experienced care providers with high-risk deliveries. In a simulated resuscitation, we hypothesized that teleneonatal resuscitation, compared to usual resuscitation, would reduce the no-flow fraction. This was a single-center, randomized simulation trial in which pediatric residents were randomized to teleneonatal or routine resuscitation. The primary outcome was no-flow fraction defined as time without chest compressions divided by the time during which the heart rate was <60. Secondary outcomes included corrective modifications of bag-mask ventilation and times to intubation and epinephrine administration. Fifty-one residents completed the scenario. The no-flow fraction (median [IQR]) was significantly better in the teleneonatal group (0.06[0.05]) compared to the routine resuscitation group (0.07[0.82]); effect (95% CI): -16 (-43 to 0). Participants in the teleneonatal resuscitation group more frequently performed corrective modifications to bag-mask ventilation (60% vs 15%; p < 0.001). Time to intubation (214 s vs 230 s; p = 0.58) and epinephrine (395 s vs 444 s; p = 0.21) were comparable between groups. In this randomized simulation trial of neonatal resuscitation, teleneonatal resuscitation reduced adverse delivery outcomes compared to routine care. Further in hospital evaluation of teleneonatology may substantiate this technology's impact on delivery outcomes. NCT04258722 IMPACT: Whereas telemedicine-supported neonatal resuscitation may improve the quality of resuscitation within hospital settings, unique challenges include the need for real-time, high-fidelity audio-video communication with a low failure rate. The no-flow fraction, which evaluates the quality of chest compressions when indicated, has been associated with survival in other clinical contexts. We report a reduction in no-flow fraction in neonatal resuscitations supported with telemedicine, in addition to improvements in the quality of neonatal resuscitation. Telemedicine-supported neonatal resuscitation may improve the quality of resuscitation within hospital settings without direct access to neonatologists.