The program has enhanced access to specialty care for
rural individuals in Arkansas and has resulted in:
- Decreased distance that many individuals in Arkansas
have to travel to be seen by an obstetric expert via
telemedicine by equipping over 40 rural sites with needed
- Development of 178 obstetrical and neonatal
guidelines for rural providers
- An increase in Medicaid beneficiaries delivering
premature or low birthweight babies at facilities with
appropriately staffed NICU services
- Fewer complications for high-risk individuals and
- Cost savings for Arkansas' Medicaid program due to
- 0.5% decrease in 60-day infant mortality rate
- Over 2,700 telemedicine visits in fiscal year 2021
for expectant mothers
- Over 1,800 tele-ultrasounds conducted in fiscal year
- Over 300 high-risk OB consults in fiscal year 2021
- Over 172,000 calls answered, with 5,786 nurse triage
calls in fiscal year 2021
- 275 back transports to rural hospitals in 2019 for
mothers and infants who delivered at urban facilities but
could be clinically managed nearer home
- Over 150 tele-fetal-echocardiography visits in fiscal
From 2018 to 2019, 39 patients reported on their
satisfaction with services:
- 96% of patients reported they were happy with their
- 95% of patients found that their providers usually or
always explained things in a way that was understood
- 87% of patients said scheduling was largely
- 60% of patients said they liked telehealth services
since they were not required to "travel to the telehealth
- 11% said they liked telehealth services since they
"did not have to find someone to take care of their
- 50% of patients traveled less than 30 miles to attend
their telehealth appointment
- Over 60% would have had to travel over 70 miles from
home if telehealth weren't an option
- The self-reported savings is
between $75 to $150 per visit
A recent provider survey that polled 84 physicians
- 100% of providers agreed that "I would use [the]
services again if needed" or "[The] services are
important for the state of Arkansas"
- Over 97% of providers reported that services are
- Transportation is a key barrier
to receiving care; traveling to Little Rock is a "major
venture for most people, so they come to us where we can
The program was honored with the American Telemedicine
Association's President's Award for Innovation in 2007
and its Institutional Award for Advancement of
Telemedicine in 2011. The program was also a core member
of the Agency for Healthcare Research and Quality (AHRQ)
Medicaid Care Management Learning Network in 2005. The
program contributed to the designation of UAMS as the
South Central Telehealth Resource Center by the Health
Resources and Services Administration (HRSA) and to the
designation of UAMS as an HRSA Telehealth Focused Rural
Health Research Center.
You can learn more about the program by reading its
annual reports and newsletters.
For more detailed information on the program's results:
Bronstein, J.M., Ounpraseuth, S., & Lowery, C.L. (2020).
Improving Perinatal Regionalization: 10 Years of
Experience with an Arkansas Initiative. Journal of
Perinatology, 40(11), 1609-1616.
Hughes, D.S., Ussery, D.J., Woodruff, D.L., Sandlin,
A.T., Kinder, S.R., & Magann, E.F. (2015). The Continuing
Antenatal Management Program (CAMP): Outpatient
Monitoring of High-Risk Pregnancies. Keeps Patients Safe,
Costs Low and Care Nearby. Sexual & Reproductive
Healthcare, 6(2), 108-109.
Lowery, C.L., Bronstein, J.M., Benton, T.L., & Fletcher,
D.A. (2014). Distributing Medical Expertise: the
Evolution and Impact of Telemedicine in Arkansas.
Health Affairs (Millwood), 33(2), 235-243.
Long, M.C., Angtuaco, T., & Lowery, C. (2014). Ultrasound
in Telemedicine: Its Impact in High-Risk Obstetric Health
Care Delivery. Ultrasound Quarterly, 30(3),
Kim, E.W., Teague-Ross, T.J., Greenfield, W.W., Williams,
D.K., Kuo, D., & Hall, R.W. (2013). Telemedicine
Collaboration Improves Perinatal Regionalization and
Lowers Statewide Infant Mortality. Journal of
Perinatology, 33(9), 725-730.
Ounpraseuth, S., Gauss, C.H., Bronstein, J., Lowery, C.,
Nugent, R., & Hall, R. (2012). Evaluating
the Effect of Hospital and Insurance Type on the Risk of
1-Year Mortality of Very Low Birth Weight Infants:
Controlling for Selection Bias. Medical Care,
Magann, E.F., Bronstein, J., McKelvey, S.S., Wendel, P.,
Smith, D.M., & Lowery, C.L. (2012). Evolving
Trends in Maternal Fetal Medicine Referrals in a Rural
State Using Telemedicine. Archives of Gynecology
and Obstetrics, 286(6).
Bronstein, J.M., Ounpraseuth, S., Jonkman, J., Fletcher,
D., Nugent, R.R., McGhee, J., & Lowery, C.L. (2012). Use
of Specialty OB Consults during High-Risk Pregnancies in
a Medicaid-Covered Population: Initial Impact of the
Arkansas ANGELS Intervention. Medical Care Research
Review, 69(6), 699-720.
Wingate, M.S., Bronstein, J., Hall, R.W., Nugent, R.R., &
Lowery, C.L. (2012). Quantifying Risks of Preterm Birth
in the Arkansas Medicaid Population, 2001-2005.
Journal of Perinatology, 32(3), 176-193.
Bronstein, J.M., Ounpraseuth, S., Jonkman, J., Lowery,
C.L., Fletcher, D., Nugent, R.R., & Hall, R.W. (2011).
Perinatal Regionalization for Preterm Deliveries in a
Medicaid Covered Population: Initial Impact of the
Arkansas ANGELS Intervention. Health Services
Research Journal, 46(4), 1082-1103.
Bibliography of articles