ANGELS and University of Arkansas for Medical Sciences paradigm for distant obstetrical care delivery.

Abstract

This article describes the process by which the Arkansas Medicaid Program, the University of Arkansas for Medical Sciences (the state's only academic health center), and Arkansas' practicing physicians are collaborating to improve the process of perinatal regionalization by providing access to expertise, education, and support of maternal-fetal medicine specialists. The described ANGELS model encourages replication among other programs that wish to improve perinatal regionalization attempts in their service areas. Through this unique collaboration, ANGELS is composed of 5 distinctive elements: a statewide telemedicine and clinic network, an education and support program for obstetric providers, case management services, a 24-hour Call Center, and an evidence-based guidelines development and distribution network. Since Arkansas has undertaken perinatal regionalization, technology has allowed the state's only group of board-certified maternal-fetal medicine specialists, located centrally in Little Rock, to provide real-time clinical support to physicians, as well as consultation or direct care to patients statewide. ANGELS' continued efforts have the potential to significantly improve perinatal care in rural areas throughout the state, while the cost of maternal and fetal health care could decline. The program's design, although unique, can be replicated elsewhere to encourage perinatal regionalization.