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Learning Objective #1: describe how an APN can facilitate the care of high-risk pregnant patients at a distant site through telemedicine.

Learning Objective #2: explain the current telemedicine technology and how an APN can facilitate collaboration of specialists through telemedicine.

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Advanced Practice Nurses (APN) play an integral role in the facilitation of high-risk obstetrical telemedicine clinics serving rural Arkansas, at which increasing numbers of patients seek telemedicine consultation. As assessed through telemedicine, the APN facilitator provides a thorough report to the provider on the patient's medical history and present obstetrical condition. The APN's documentation of pertinent clinical information such as Level II ultrasound findings, recommendations, and future management plans enables the MFM specialist to move with ease from patient to patient, thus increasing the number of high-risk patients receiving consultation. The APN directs the virtual clinic room utilized by providers, assisting with camera and volume manipulation to enhance the telemedicine experience for the provider and patient. Since the integration of APN facilitation in telemedicine consultation, the University of Arkansas for Medical Sciences has witnessed a marked increase in the number of telemedicine consultations conducted. In 2002, only 174 telemedicine consultations were conducted, whereas in 2005, 548 consultations were conducted, as attributed to the implementation of a high-risk pregnancy telemedicine program relying on regular APN facilitation. Virtual high-risk obstetrical clinics facilitated by an APN can enhance provider availability to an increased number of patients by streamlining the telemedicine consultation process.