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Paging the worldwide cardiology consultant: the Army Knowledge Online Telemedicine Consultation Program in cardiology
Elden R Rand1, Charles M Lappan, Joseph C Lee
1Cardiology Service, Department of Medicine, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234-6200, USA.
Insights
Cardiology teleconsultation via the Army Knowledge Online (AKO) program effectively supports deployed medical teams. This service reduces medical evacuations and associated costs for military personnel in austere environments.
Area of Science:
- Military Medicine
- Cardiology
- Telehealth
Background:
- Deployed personnel in austere environments require cardiovascular care.
- Aeromedical evacuations for cardiac issues are resource-intensive.
- The Army Knowledge Online (AKO) Telemedicine Consultation Program was established to provide remote specialist support.
Purpose of the Study:
- To evaluate the utility and impact of cardiology teleconsultations for deployed military medical providers.
- To assess the effectiveness of the AKO Telemedicine Consultation Program in managing cardiovascular conditions remotely.
Main Methods:
- Analysis of cardiology teleconsultations managed through the AKO program over 3.5 years.
- Electronic consultations were initiated via text page to on-call cardiologists.
- Data collected included reasons for consultation, response times, and patient disposition.
Main Results:
- 207 cardiology teleconsultations were managed with an average response time of 4 hours 54 minutes.
- Common reasons for consultation included electrocardiographic abnormalities, chest pain, and syncope.
- Six evacuations were avoided, 29 were facilitated, saving an estimated $144,000.
Conclusions:
- Cardiology teleconsultation is a valuable service for deployed medical providers.
- The program effectively decreases medical evacuation costs.
- Teleconsultation facilitates appropriate patient transfer and disposition.
Background:
Global operations place large numbers of military and nonmilitary personnel in austere environments. Aeromedical evacuation for cardiovascular issues is periodically required. The Army Knowledge Online (AKO) Telemedicine Consultation Program was initiated by the Office of the Surgeon General to electronically link deployed medical providers with subspecialty consultants to assist and guide triage and disposition.
Methods:
Electronic consultation triggered a text page to an on-call staff cardiologist at Brooke Army Medical Center. Cardiology teleconsultations for the first 3.5 years were analyzed.
Results:
Two hundred seven cardiology teleconsults were managed, with an average response time of 4 hours 54 minutes. The three most prevalent reasons for teleconsultation were electrocardiographic abnormalities, chest pain syndromes, and syncope. Six evacuations were avoided; 29 evacuations were facilitated. An estimated $144,000 was saved, plus intangible benefits.
Conclusions:
Cardiology teleconsultation provides a valuable service to deployed providers, decreases medical evacuation costs, and facilitates transfer of patients to appropriate facilities.
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