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The evolution of pediatric tele-echocardiography: 15-year experience of over 10,000 transmissions
Anita Krishnan1, Mary Fuska, Ron Dixon
1Children's National Heart Institute, Children's National Medical Center , Washington, D.C.
Insights
Internet protocol (IP) technology significantly increased telemedicine echocardiogram use for infant heart disease evaluation. This expansion enhanced telecardiology utilization without negatively impacting efficiency or diagnostic accuracy.
Area of Science:
- Cardiology
- Telemedicine
- Medical Informatics
Background:
- Telemedicine facilitates echocardiogram transmission for infant heart disease diagnosis.
- The effect of Internet protocol (IP) technology on telecardiology use was previously unclear.
- This study investigates IP expansion's impact on telecardiology utilization and scanning methods.
Purpose of the Study:
- To assess the influence of IP technology on telecardiology utilization.
- To analyze changes in echocardiogram transmission modes (live vs. store-and-forward).
- To evaluate the efficiency and diagnostic outcomes of telecardiology.
Main Methods:
- A retrospective review of a telemedicine database (1998-2012).
- Comparison of telecardiology utilization and transmission modes before and after IP introduction in 2006.
- Recording of indications, outcomes, effectiveness, and efficiency of telemedicine echocardiograms.
Main Results:
- Telecardiology utilization rose significantly post-IP expansion, with over 11,890 transmissions recorded.
- A shift from live to store-and-forward transmission modes was observed.
- Diagnostic accuracy and efficiency remained unaffected, with abnormalities found in over 40% of studies.
Conclusions:
- IP technology adoption at a single center led to a substantial increase in telemedicine echocardiogram volume.
- No significant adverse effects on efficiency or diagnostic accuracy were noted.
- Telecardiology remains an effective tool for evaluating pediatric cardiac conditions.
Background:
Telemedicine transmission of echocardiograms, either in real-time or using store-and-forward technology, is used to evaluate infants with suspected heart disease. The impact of Internet protocol (IP) technology on telecardiology utilization is unknown. This study evaluated the impact of IP expansion on telecardiology utilization and mode of scanning.
Materials And Methods:
The telemedicine database from 1998 to 2012 at our institution was reviewed. Tele-echocardiography transmissions between 1998 to 2012 were identified. IP technology was introduced in 2006. The database was reviewed to compare telecardiology utilization and mode of scanning of transmission (live, store-and-forward, or both). As a secondary aim, indications for telemedicine echocardiograms, outcomes of studies, effectiveness, and efficiency were recorded.
Results:
Between 1998 and 2012, 11,890 telemedicine transmissions were performed. After IP expansion, telecardiology utilization increased significantly with no adverse effect on efficiency or diagnostic accuracy. IP expansion paralleled a change from live transmissions to store-and-forward transmissions. Abnormalities were detected in over 40% of studies. The average from time of request to completion of teleconsultation was under 30 min. Over 90% of echocardiograms were performed during the videoconference in the first 2 years. This fell to under 60% during the 2 most recent years of the program without impact on accuracy.
Conclusions:
Use of IP technology at a single center corresponded to a dramatic increase in volume of telemedicine echocardiograms, with no significant differences in efficiency.