Paediatric echocardiography by telemedicine-nine years' experience

Abstract

In 1987 we established a realtime echocardiography service by telemedicine from the paediatric cardiology department of a tertiary-care hospital in Halifax. The service was initially provided to a single regional hospital but was expanded to six regional hospitals in the three Canadian Maritime Provinces. The system used a dialup broadband video-transmission service provided by the telephone companies. Records of all transmissions were kept prospectively and reviewed to January 1997. A total of 324 transmissions were made. During 1995- 96 there were 135 studies: 69 51 were urgent examinations of newborn children and 30 22 were urgent examinations of older children; repeat studies and postoperative checks usually for pericardial effusion accounted for the other 36 studies 27 . The images were of broadcast quality except in five cases where problems with transmission or poor sedation occurred. A comparison of 26 transmitted studies with repeat, in person' studies showed no important discrepancies in diagnosis. During the two-year study period, the cost of the network equipment leasing costs and telecommunications costs was C 90,000. Use of the telemedicine network saved unnecessary patient transfer in 31 cases. The cost of the transportation avoided was C 100,000-C 118,000. This review confirms our preliminary findings that broadband echocardiography transmission provides a service comparable in availability and accuracy to that provided in our paediatric cardiology division.