Home videoconferencing for patients with severe congential heart disease following discharge.
BACKGROUND
Centralization of pediatric cardiology services into a small number of tertiary centers and the particular stress that accompanies diagnosis and surgical management of severe congenital heart disease (CHD) renders psychological support for families and clinical monitoring of patients following discharge increasingly important. Telemedicine has an increasing role in clinical and academic medicine. Improvements in quality and reliability of videoconferencing systems have allowed this to become a useful diagnostic tool.


OBJECTIVE
This study aimed to assess the benefits of home monitoring by videoconferencing compared with contacting by telephone only, in terms of decreasing anxiety levels and clinical monitoring in the postdischarge period.


METHODS
We performed a prospective, controlled study of children with a recent diagnosis of severe CHD and those recovering from palliative or corrective surgery for severe CHD. We used standardized anxiety scores to assess anxiety after discharge in families followed up by home videoconferencing or telephone calls and assessed the clinical information available through videoconferencing or telephone calls by structured questionnaires.


RESULTS
Videoconferencing decreased anxiety levels compared with telephone calls (P < .05). Improved clinical information was available in the videoconferencing group, resulting in more appropriate and timely hospital attendance.


CONCLUSIONS
Videoconferencing is acceptable to parents and physicians and provides a more effective form of follow-up in terms of clinical observation and parental anxiety levels.
Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Royal Group of Hospitals, Belfast, Ireland. hotmorgan@doctors.net.uk
Gareth J
GJ
Morgan
Brian
B
Craig
Brian
B
Grant
Andrew
A
Sands
Nicola
N
Doherty
Frank
F
Casey
D001007:Anxiety / Q000517:prevention & control; D006348:Cardiac Surgical Procedures; D002648:Child; D017048:Health Care Costs; D006330:Heart Defects, Congenital / Q000523:psychology / Q000601:surgery / Q000628:therapy; D006801:Humans; D010290:Parents / Q000523:psychology; D010351:Patient Discharge; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000523:psychology / Q000628:therapy; D011446:Prospective Studies; D012944:Social Support; D013689:Telephone; D049269:Videoconferencing / Q000191:economics