A preliminary assessment of Internet-based nuclear telecardiology to support the clinical management of cardiac disease in a remote community.
A portable nuclear medicine (NM) processing system was established in Kalgoorlie and an acute myocardial perfusion scintigraphy (MPS) service was provided for the local regional hospital. After scanning the patient, the data were processed on a laptop computer and JPEG images were transmitted to a secure Web server. A secure email message, with the URL link enclosed and a provisional indication of normal or abnormal findings, was sent to the referring clinician from the NM facility. Use of the Internet allowed for a group consultation between the NM technician, the referrer and the cardiologist in Perth. During a three-month study period, 42 patients were referred for exclusion of acute coronary syndrome. Of these, 21 (50%) demonstrated abnormal perfusion studies, two of which were classified as requiring urgent medical intervention. Seventeen studies were normal (41%) and four (10%) were designated equivocal. There was an alteration in the treatment plan for 32 patients (76%), including four for whom admission or further investigation was deemed unwarranted. The results suggest that MPS findings, distributed via the Internet, allow for earlier risk stratification and have a direct affect on clinical decision making.
Tually
Peter
P
Imaging the South, Department of Nuclear Medicine, Western Australia. p.tually@imagingthesouth.com.au
Janssen
Johan
J
Cowell
Simon
S
Walker
John
J
D000328:Adult; D000368:Aged; D001315:Australia; D005240:Feasibility Studies; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation; D020407:Internet; D008297:Male; D008875:Middle Aged; D009683:Nuclear Medicine; D011877:Radionuclide Imaging; D019114:Remote Consultation; D019035:Rural Health Services / Q000458:organization & administration*