title: 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 single regional hospital but was expanded to six regional hospitals in the three Canadian Maritime Provinces. The system used a dial-up 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.
authors.affiliation: Department of Pediatric Cardiology, IWK Grace Health Centre, Halifax, Nova Scotia, Canada. jfinley@iwkgrace.ns.ca
authors.forename: J P
authors.initials: JP
authors.lastname: Finley
authors.forename: G P
authors.initials: GP
authors.lastname: Sharratt
authors.forename: M A
authors.initials: MA
authors.lastname: Nanton
authors.forename: R P
authors.initials: RP
authors.lastname: Chen
authors.forename: P
authors.initials: P
authors.lastname: Bryan
authors.forename: J
authors.initials: J
authors.lastname: Wolstenholme
authors.forename: C
authors.initials: C
authors.lastname: MacDonald
mesh_terms: D002170:Canada; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D004452:Echocardiography; D005069:Evaluation Studies as Topic; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010372:Pediatrics / Q000191:economics / Q000379:methods*; D011446:Prospective Studies; D017216:Telemedicine / Q000191:economics / Q000379:methods*; D013686:Telemetry; D014187:Transportation of Patients / Q000191:economics