A Medico-Socio-Economic Analysis of TeleEKG in Ivory Coast

TeleEKG is gradually being integrated into the care offered to the most isolated Ivorian populations, however, no medico-socio-economic analysis of its impact has yet been conducted. The aim of this study was to assess the medico-socio-economic impact of a teleEKG network in the provision of cardiology care in Ivory Coast. A retrospective study of the data transmitted by the 10 centers involved in the pilot phase of the teleEKG project from January 2015 to December 2017. The average ratio between the cost to the patient of performing an electrocardiogram (EKG) according to the traditional practice and using a teleEKG was 3.8 ± 1.64. The distance avoided by the 6,045 patients was 1,074,090 km (average 177.7 km/patient). The 6,045 teleEKGs carried out over the period of the study produced a total revenue of 36,270,000 XOF (55,290 EUR) or an average revenue per site of 3,627,000 XOF (5,529 EUR). Dyspnea on exertion (22%), and hypertension (21%) were the main indications for performing the EKG, and left ventricular hypertrophy was the most common electrical anomaly detected (19.8%). Acute coronary syndrome with persistent ST segment elevation was diagnosed in 0.7% of cases (40 cases) and atrial fibrillation in 1.12% of cases (68 cases). These results confirm the key role telemedicine can play in the treatment of heart conditions in rural populations and the economic sustainability of such telemedicine networks. teleEKG offers economic accessibility to cardiology care for isolated populations in Ivory Coast.