title: [Is transmission of heart murmurs via e-mail cost saving?].
abstract: BACKGROUND
  The use of pre-recorded heart murmur in an electronic referral for a remote consultation can save children and their parents from having to travel to the nearest out-patient clinic. The heart sound can be recorded by the GP at the local health clinic and sent by e-mail to the specialist. 41 clinics in the North Norway healt region have invested in equipment that makes pre-recorded sound referrals possible. This study analyses whether this investment is a cost-saving technology or not.
  
  
  METHODS
  A yearly average of 50 children with a heart murmur are referred to a specialist in Troms. The costs of using pre-recorded telemedicine were compared to the costs of patient travelling to the nearest secondary care centre.
  
  
  RESULTS
  Pre-recorded heart sound referrals cost from 216 000 NOK more per year than the alternative of bringing patients to the out-patient clinic. The number of children with a heart murmur needed in order to break even must exceed 195 per year, i.e. 1.7 children per GP per year.
  
  
  CONCLUSIONS
  The number of children with a heart murmur in Troms is too low for this method to be a cost-saving approach.
authors.affiliation: Nasjonalt senter for telemedisin, Postboks 35, 9038 Tromsø. trine.bergmo@telemed.no
authors.forename: Trine S
authors.initials: TS
authors.lastname: Bergmo
authors.forename: Lauritz Bredrup
authors.initials: LB
authors.lastname: Dahl
authors.forename: Toralf
authors.initials: T
authors.lastname: Hasvold
mesh_terms: D002648:Child; D017046:Cost Savings; D017281:Cost of Illness; D034742:Electronic Mail; D004582:Electronics, Medical; D017048:Health Care Costs; D006326:Heart Auscultation / Q000191:economics / Q000379:methods*; D006337:Heart Murmurs / Q000175:diagnosis* / Q000191:economics; D006347:Heart Sounds; D006801:Humans; D009664:Norway; D019114:Remote Consultation / Q000191:economics / Q000379:methods; D019023:Stethoscopes