Remote diagnosis of congenital heart disease: the impact of telemedicine

Grant, Brian; Morgan, Gareth J.; McCrossan, Brian; Crealey, Grainne; Sands, Andrew J; Craig, Brian; Casey, Frank

doi:10.1136/adc.2008.146456

Cited by 44 publications

(57 citation statements)

References 22 publications

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“…Indeed, the benefits of the use of telemedicine in adult and pediatric intensive care have already been demonstrated. [4][5][6][7][8][9] As for neonatal care, there is a growing body of literature on the use of telemedicine primarily at remote areas for the provision of staff and parent education, [10][11][12] neonatology and other subspecialty consultations 10,[13][14][15] and expert interpretation of echocardiographic [16][17][18][19][20][21] and radiographic 22 images. The findings of some of these studies suggest that the use of telemedicine improves quality of care and parental satisfaction and may decrease healthcare costs and length of hospitalization of neonates requiring intensive care.…”

Section: Introductionmentioning

confidence: 99%

The use of mobile robotic telemedicine technology in the neonatal intensive care unit

et al. 2011

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Objective: To describe the use of a wireless, mobile, robotic telecommunications system in the Neonatal Intensive Care Unit (NICU).Study Design: In this prospective study utilizing 304 patient encounters on 46 preterm and term neonates in a level IIIa NICU, a bedside neonatologist ('on-site neonatologist'; ONSN) and a neonatologist at a distant location ('off-site neonatologist'; OFFSN) evaluated selected demographic information, laboratory data and clinical and radiological findings of the subjects. The OFFSN used a commercial wireless, mobile, robotic telecommunications system controlled from a remote site. The two physicians were blinded to each other's findings and agreement rates of the evaluations between the ONSN and the OFFSN were compared using kappa statistics. Agreement rates between two ONSNs using the same protocol with 39 patient encounters served as the reference standard. The dependability and timeliness of data transmission were also assessed.Result: Excellent or intermediate-to-good agreements were noted for all but a few physical examination assessments between both the ONSN and OFFSN and the two ONSNs. Poor agreements were found for certain physical examination parameters (breath-, heart-and bowel-sounds and capillary refill time) with or without the use of telemedicine. The median duration of the encounters by the ONSN and OFFSN and the two ONSNs was similar. Five encounters were excluded from the analysis because of technical difficulties. No complications associated with the use of the mobile robot were noted. Conclusion:Our findings indicate that the use of mobile robotic telemedicine technology is feasible for neonates in the NICU.

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Section: Introductionmentioning

confidence: 99%

The use of mobile robotic telemedicine technology in the neonatal intensive care unit

et al. 2011

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“…More recent studies also demonstrate that tele-echocardiography helps avoid potentially risky transfers of sick newborn babies between hospitals. (Grant et al, 2010) Most importantly, neonatal teleechocardiography has become accepted as an integral part of many regional paediatric cardiology services across the world. The value of telemedicine in continuing professional development has been well documented if not fully researched.…”

Section: Critical Aortic Stenosismentioning

confidence: 99%

“…Northern Ireland is a small geographical area, therefore the potential saving for larger regions is even greater. (Grant et al, 2010) One of the main barriers to increased use of telemedicine is the initial start up cost. Running costs for ISDN 6 lines are also significant.…”

Section: Economic Analysismentioning

confidence: 99%

“…There are many articles in the literature confirming the effectiveness of this telemedicine application. (Finley et al, 1997;Mulholland et al, 1999;Sable, 2003;Widmer et al, 2003;Grant et al, 2010) (Tsilimigaki et al, 2001) 2.2.1 Clinical imperative 1. It can be challenging to confidently rule out CHD in the differential diagnosis of a critically ill newborn baby.…”

Section: Tele-echocardiography In Paediatricsmentioning

confidence: 99%

“…(Mulholland et al, 1999;Sable et al, 1999;Widmer et al, 2003;Grant et al, 2010) Store and forward formats have also been utilised but in this situation the paediatric cardiologist must be confident that the echocardiographer will obtain a detailed and complete echocardiographic study. If the echocardiographer is capable of performing such a study it is questionable whether further interpretation is necessary.…”

Section: Critical Aortic Stenosismentioning

confidence: 99%

See 2 more Smart Citations

Telemedicine in the Diagnosis and Managemnt of Congenital Heart Disease

Casey¹,

McCrossan²

2011

Telemedicine Techniques and Applications

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Feasibility and Accuracy of Tele‐Echocardiography, With Examinations by Nurses and Interpretation by an Expert via Telemedicine, in an Outpatient Heart Failure Clinic

Hjorth‐Hansen

Andersen

Graven

et al. 2020

J of Ultrasound Medicine

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Objectives-To study the feasibility and accuracy of focused echocardiography by nurses supported by near-real-time interpretation via telemedicine by an experienced cardiologist. Methods-Fifty consecutive patients were included from an outpatient heart failure (HF) clinic. Limited echocardiography was performed by 1 of 3 specialized nurses. The echocardiograms were transferred by a secure transfer model for near-real-time interpretation to 1 out-of-hospital cardiologist, assessing, among others, the left ventricular (LV) internal diameter, end-diastolic volume, ejection fraction, left atrial (LA) indexed end-systolic volume, mitral early inflow velocity (E), the ratio of E to mitral late inflow, and the ratio of E to the mitral annular early diastolic velocity. The reference method was echocardiography by 1 of 4 experienced cardiologists. Results-The median age of the population (46% women) was 79 (range, 33-95) years. The assessment and quantification of LA and LV dimensions, volumes, and functional indices were feasible in 94% or more via the telemedical approach. The agreement with reference measurements was very high by the telemedical approach. The mean duration AE SD of the complete telemedical approach from the start of echocardiography until the cardiologist's report was received by the caregiving nurse was 1.32 AE 0.36 (range, 1.58) hours. The correlations with reference to the above-specified indices were r = 0.75 to 0.94. Conclusions-Limited echocardiography by nurses in an outpatient heart failure clinic, supported by interpretation by an out-of-hospital cardiologist, was feasible and reliable. This may reduce geographic disparities and allow more patients to benefit from the advantages of implementing focused echocardiography by noncardiologists in diagnostics and follow-up.

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Remote diagnosis of congenital heart disease: the impact of telemedicine

Abstract: CHD is accurately diagnosed by realtime transmission of echocardiograms performed by paediatricians under live guidance and interpretation by a paediatric cardiologist. Remote diagnosis and exclusion of CHD affects patient management and may be cost saving.

Cited by 44 publications

References 22 publications

The use of mobile robotic telemedicine technology in the neonatal intensive care unit

The use of mobile robotic telemedicine technology in the neonatal intensive care unit

Telemedicine in the Diagnosis and Managemnt of Congenital Heart Disease

Feasibility and Accuracy of Tele‐Echocardiography, With Examinations by Nurses and Interpretation by an Expert via Telemedicine, in an Outpatient Heart Failure Clinic

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