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Echocardiography by telephone--evaluation of pediatric heart disease at a distance
J P Finley1, D G Human, M A Nanton
1Department of Pediatric Cardiology, Izaak Walton Killam Children's Hospital, Halifax, Nova Scotia, Canada.
Insights
This study demonstrates the feasibility of using telephone transmission for pediatric echocardiography, enabling remote expert diagnosis. This service provides crucial access to specialist care and can prevent unnecessary transport of critically ill children.
Area of Science:
- Cardiology
- Medical Technology
- Pediatrics
Background:
- Pediatric echocardiography requires specialized expertise often unavailable in general hospitals.
- Long distances between facilities can delay diagnosis and treatment for critically ill children.
Purpose of the Study:
- To establish and evaluate a 24-hour telephone transmission service for pediatric echocardiography.
- To assess the feasibility, cost-effectiveness, and diagnostic accuracy of remote echocardiogram interpretation.
Main Methods:
- A telephone transmission service connected a general hospital with a children's hospital 500 km apart.
- Pediatric echocardiograms were transmitted in real-time for interpretation by a pediatric cardiologist.
- The service operated for 9 months, analyzing studies from 18 pediatric patients.
Main Results:
- Excellent image and sound quality were achieved during transmission.
- Complete diagnoses were made in 16 of 18 patients; 8 received new diagnoses.
- Congenital heart disease was identified in 12 patients; 4 avoided transport.
Conclusions:
- Telephone transmission of pediatric echocardiograms is feasible, cost-effective, and diagnostic.
- This service improves access to specialist expertise for remote pediatric patients.
- It can prevent hazardous and expensive transport of ill children, improving emergency care.
Abstract:
A 24-hour telephone transmission service was established for pediatric echocardiography between a general hospital and a children's hospital 500 km distant. Studies were transmitted in real time for interpretation and diagnosis by a pediatric cardiologist. In the first 9 months of operation, studies were transmitted for 18 children with a median age of 5 months. Image and sound quality was excellent. Complete segmental diagnosis was made in 16 patients, and further study was needed in 2 others. In 8 of the 18 patients a new diagnosis was provided, and in 10 patients diagnosis was confirmed. Congenital heart disease was found in 12 patients, other heart disease in 2 and a normal heart in 4. The population included 2 fetuses whose echocardiograms showed hypoplastic left heart and intracardiac tumor. In 4 patients transport was avoided. This is the first report of echocardiographic transmission by telephone, which was shown to be clearly feasible, cost-effective and diagnostic. It provides emergency access to specialist expertise, and may avoid hazardous and expensive transport of ill children.