The Evolution of Pediatric Tele-echocardiography: 15-Year Experience of Over 10,000 Transmissions

Krishnan, Anita; Fuska, Mary; Dixon, Ron; Sable, Craig

doi:10.1089/tmj.2013.0279

Cited by 18 publications

(25 citation statements)

References 25 publications

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“…Antenatal management of high-risk pregnancies from a distance has been accomplished for conditions ranging from maternal diabetes, hypertensive disorders, cervical insufficiency, and suspected fetal anomalies, including congenital heart disease (90)(91)(92). In Arkansas, telemedicine-supported care in the rural setting has been shown to reduce the need for in-person visits (where the mother would have to travel to the tertiary center) by nearly 50%, while maintaining the appropriate utilization of maternal-fetal medicine subspecialty consultations (91).…”

Section: Perinatal and Newborn Carementioning

confidence: 99%

Addressing health disparities in rural communities using telehealth

2015

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The regionalization of pediatric services has resulted in differential access to care, sometimes creating barriers to those living in underserved, rural communities. These disparities in access contribute to inferior healthcare outcomes among infants and children. We review the medical literature on telemedicine and its use to improve access and the quality of care provided to pediatric patients with otherwise limited access to pediatric subspecialty care. We review the use of telemedicine for the provision of pediatric subspecialty consultations in the settings of ambulatory care, acute and inpatient care, and perinatal and newborn care. Studies demonstrate the feasibility and efficiencies gained with models of care that use telemedicine. By providing pediatric subspecialty care in more convenient settings such as local primary care offices and community hospitals, pediatric patients are more likely to receive care that adheres to evidence-based guidelines. In many cases, telemedicine can significantly improve provider, patient, and family satisfaction, increase measures of quality of care and patient safety, and reduce overall costs of care. Models of care that use telemedicine have the potential to address pediatric specialists' geographic misdistribution and address disparities in the quality of care delivered to children in underserved communities.

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Section: Perinatal and Newborn Carementioning

confidence: 99%

Addressing health disparities in rural communities using telehealth

2015

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“…Krishnan et al 45 reported the technology transition at a single center with >10 000 telemedicine transmissions from 24 sites in 7 states and territories between 2001 and 2012. Abnormalities were detected in >40% of the studies, including >100 patients with life-threatening defects.…”

Section: Evolution Of the Technologymentioning

confidence: 99%

“…Telemedicine has the potential to alter the equation. Although no data have been published that suggest telemedicine will increase the use of echocardiography, 30,45 the potential for this to happen certainly exists. Additionally, telemedicine could decrease the need of pediatric cardiologists in more remote areas, allowing tertiary care centers to hire more cardiologists, who can then provide echocardiography interpretation remotely.…”

Section: Workforce and Trainingmentioning

confidence: 99%

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Satou¹,

Rheuban²,

Alverson³

et al. 2017

Circulation

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A dvancements in technology and broadband have revolutionized the current practice of medicine. The field of pediatric cardiology is no exception given the need for prompt diagnosis and reliance on cardiac imaging to identify infants and children with potentially life-threatening cardiovascular disease. As the relationship between telemedicine and pediatric cardiology has advanced, it has created a need to develop a broad, comprehensive document reviewing all the various aspects of telemedicine in pediatric cardiology. For more than a decade, a significant body of literature has been published describing individual experiences and practices, yet there remains no comprehensive statement or document summarizing this rapidly advancing field. In an effort to describe the collective experience and to provide structure and guidance for pediatric cardiology practitioners and healthcare providers, we have developed a scientific statement on the use of telemedicine in pediatric cardiology.Specific areas explored in this document include both neonatal and fetal teleechocardiography, implications for training community sonographers, pulse oximetry programs, qualitative improvement and appropriate use criteria initiatives, and remote electrophysiological monitoring. This document also includes teleconsultation and teleausculation, direct-to-consumer and home monitoring programs, and a look into the use of telemedicine and pediatric cardiology in the intensive care setting. Furthermore, a detailed review of the legislative, public policy, and legal aspects of telemedicine is provided, along with financial and reimbursement information.Several terms are used in the literature interchangeably; a brief explanation is provided to help readers of this document. The term telehealth is defined as the use of technology to bridge distances in any aspect of medicine; telemedicine is the specific application of technology to conduct clinical medicine at a distance. The term telecardiology is defined as the broad application of telemedicine in the field of cardiology specifically, and tele-echocardiography is the most common application used within this field. ECHOCARDIOGRAPHY AND TELEMEDICINEEchocardiography is the most commonly used noninvasive cardiovascular imaging modality and is considered to be both safe and cost-effective. Tele-echocardiography can be described as a process in which a provider or a technician obtains cardiovascular ultrasound images from a given patient and these images are subsequently transmitted to an offsite location where a cardiologist can provide further analysis and interpretation. Thus, tele-echocardiography enables expert interpretation and consultation in a rapid and potentially geographically disparate fashion, enabling prompt and accurate decision making involving triage, transport, and therapeutic priorities. Tele-echocardiography is now routinely used across the age and subspecialty spectrum in pediatric cardiology.

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“…Although beneficial to patient care, flexibility is a limitation. The advent of the Internet and wireless communication enabled versatile, low cost, and rapid transmission between multiple access points, which was revolutionary for telemedicine . Increased Internet bandwidth enabled the faster transmission of larger stored image files and real‐time transmission of video files of higher image quality and frame rate .…”

Section: Historical Perspective and Future Directionsmentioning

confidence: 99%

“…If an immediate discussion is not needed, stored or captured videos and still image files or connecting hyperlinks can be shared. This capture and send approach to sharing images allows the recipient to continue with the current clinical work and review the sent information later …”

Section: Introductionmentioning

confidence: 99%

A practical guide to graphic communication for quality assurance, education, and patient care in echocardiography

Cohen

2019

Echocardiography

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Graphic communication (GC) is useful for continuous quality improvement (CQI), education, and patient care when in‐person discussion is not possible because of geographic and schedule constraints. In echocardiography, these constraints can be mitigated by (a) capturing screenshots and device photos or videos and sharing them by email or text message, (b) simultaneous viewing of images on digital displays, and (c) broadcasting the study real time during acquisition to other mobile or stationary devices. Screenshots are useful for CQI and education and can be acquired, annotated, and shared with minimal impact on the flow of clinical echo interpretation. Providers at different locations can employ GC for shared clinical decision making by viewing echo studies from the same server, video conferencing or accessing real‐time broadcast from a device. Which GC tool is selected is determined by its ease of use, the provider's goals and whether immediate image review is needed.

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The Evolution of Pediatric Tele-echocardiography: 15-Year Experience of Over 10,000 Transmissions

Abstract: Use of IP technology at a single center corresponded to a dramatic increase in volume of telemedicine echocardiograms, with no significant differences in efficiency.

Cited by 18 publications

References 25 publications

Addressing health disparities in rural communities using telehealth

Addressing health disparities in rural communities using telehealth

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

A practical guide to graphic communication for quality assurance, education, and patient care in echocardiography

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