Remote Patient Monitoring for Neonates Discharged Home on Nasogastric Tube Feeds: A Multicenter Survey of Practices, Eligibility Criteria, and Implementation Barriers

OBJECTIVE: To characterize institutional practices, eligibility criteria, monitoring strategies, and perceived barriers related to remote patient monitoring (RPM) for neonates discharged home on nasogastric tube (NGT) feeds across Children's Hospital Neonatal Consortium (CHNC) institutions. METHODS: We conducted a cross-sectional, web-based survey of neonatal care providers across CHNC institutions. The survey assessed eligibility criteria for home NGT feeding, RPM implementation protocols, feeding regimens, follow-up practices, monitoring duration, outcomes tracked, and perceived barriers. Responses were collected anonymously via Research Electronic Data Capture and analyzed using descriptive statistics. RESULTS: A total of 25 centers responded (50% response rate), with most respondents from neonatology (96%). Overall, 84% of centers reported discharging selected neonates home on NGT feeds, and 75% of centers without an established home NGT program planned implementation within 1-2 years. Medical stability (90.5%) and reliable caregiver involvement (85.7%) were commonly required, although eligibility criteria varied. Monitoring platforms, frequency, and duration were heterogeneous, with 61.9% continuing monitoring until NGT discontinuation. Fewer than half (47.6%) reported billing for home NGT monitoring services. Commonly tracked outcomes included growth (61.9%), gastrostomy tube placement (52.4%), and readmissions (47.6%). Major barriers included limited staffing support (66.7%), staff time commitment (57.1%), and reimbursement concerns (42.9%). CONCLUSIONS: Home NGT feeding is commonly practiced among the responding CHNC institutions; however, eligibility and monitoring practices vary considerably. Consensus-based eligibility criteria, standardized monitoring and outcome measures, and sustainable staffing and reimbursement models may improve consistency and facilitate evaluation of these programs.