title: Remote-controlled robotic arm for real-time echocardiography: the diagnostic future for patients in rural areas?
abstract: There exists a great clinical need for improving specialist consultation and utilization of echocardiography in areas remote from hospital-based care. This paper presents the development and first technical assessment of a concept of cardiovascular consultation utilizing long distance, real-time echocardiography as a diagnostic tool in rural areas. The development of CARdiological consultation at a DISTance (CARDISTA) was achieved in three stages, comprising tests of different broadband infrastructures, videoconference systems, microphones, cameras, monitors, and loudspeakers. The CARDISTA concept includes a cardiologist and a sonographer, a robotic arm (Medirob), a portable ultrasound machine, and presently available information technology using an advanced broadband backbone. The three stages provided, with some remaining doubts, echocardiographic examination at a distance comparable to hospital-based examinations. A continuous broadband capacity of 20 megabits per second (Mbps) seemed to be a vital component of CARDISTA for achieving the highest-quality imaging. With this broadband capacity, it was possible to achieve a transmission delay below 200 ms. The technical tests of the CARDISTA concept revealed promising results in enabling long distance real-time echocardiography for specialist consultation. CARDISTA is now ready for clinical testing and evaluation in rural areas for patients with heart diseases, especially heart failure.
authors.affiliation: Department of Medicine, Skellefteå County Hospital, Skellefteå, Sweden. kurt.boman@vll.se
authors.forename: Kurt
authors.initials: K
authors.lastname: Boman
authors.forename: Mona
authors.initials: M
authors.lastname: Olofsson
authors.forename: Johan
authors.initials: J
authors.lastname: Forsberg
authors.forename: Sven-Ake
authors.initials: SA
authors.lastname: Boström
mesh_terms: D006801:Humans; D012371:Robotics; D012424:Rural Population; D019112:Teleradiology; D013997:Time Factors