title: Telemedicine applications for the regional paediatric cardiology service in Northern Ireland.
abstract: The regional paediatric cardiology centre in Northern Ireland has a telemedicine network linking the neonatal units of three district general hospitals using ISDN and IP-compliant equipment. We have previously reported the use of ISDN transmission at 128 kbit/s for remote echocardiography. In a series of 61 patients, a total of 59 transmitted scans were of sufficient diagnostic quality to confirm or exclude the presence of major congenital heart disease (CHD). There were three diagnostic errors (7%). Subsequently, we have examined the use of ISDN transmission at 384 kbit/s. Echocardiographic studies were carried out on 21 patients and all were followed up. Fourteen patients (67%) had CHD confirmed. There were two diagnostic errors (10%). Our experience of transmitting live echocardiographic images suggests that ISDN at 384 kbit/s provides the optimum balance between the clarity of the transmitted images and costs. We expect that IP videoconferencing will offer similar quality but at a lower running cost, and are currently assessing it in a pilot study. All sites within our network will remain capable of ISDN transmission until the efficacy and reliability of IP transmission has been demonstrated in a controlled trial. The clinical telemedicine service has led to the earlier diagnosis of and instigation of appropriate treatment for CHD.
authors.affiliation: Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, UK. briangrant@doctors.org.uk
authors.forename: B
authors.initials: B
authors.lastname: Grant
authors.forename: J G
authors.initials: JG
authors.lastname: Wallace
authors.forename: R A
authors.initials: RA
authors.lastname: Hobson
authors.forename: B G
authors.initials: BG
authors.lastname: Craig
authors.forename: H C
authors.initials: HC
authors.lastname: Mulholland
authors.forename: F A
authors.initials: FA
authors.lastname: Casey
mesh_terms: D003195:Computer Communication Networks / Q000295:instrumentation / Q000592:standards; D003327:Coronary Disease / Q000175:diagnosis*; D004452:Echocardiography; D004867:Equipment Design; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D009660:Northern Ireland; D017216:Telemedicine / Q000379:methods*