title: A medical link between local maternity hospitals and a tertiary center using telediagnosis with fetal cardiac ultrasound image transmission.
abstract: Information and communication technology has been widely applied to various fields, including clinical medicine. We report here a telediagnosis system using ultrasound image transmission. The effect of telediagnosis, using a medical link between local maternity hospitals and our children's medical center, was verified. The number of fetal telediagnosis for cardiac disease, and cases referred to a perinatal care center and emergent transportation of neonates with congenital heart disease from maternity hospitals, were calculated based on the hospital records. The percentage of patients found to have heart disease was compared between out-patient clinic and telediagnosis cases. Telediagnosis increased, allowing maternity hospital staff to obtain support easily from a specialist when making a diagnosis. Many severe cases were transferred to tertiary centers with the correct diagnosis; consequently, the number of emergent transportations of neonates with severe cardiac anomalies continued to below. Telediagnosis was also useful as an educational tool for maternity hospital staff, who improved their skills during conversations with a specialist. Unlike in the outpatient clinic, consultation by telediagnosis was requested even for cases of mild abnormalities, and the number of false-positives increased, while many cardiac anomalies were found in the early stage. Furthermore, telediagnosis was helpful for pregnant women requiring bed rest, and also had the advantage of allowing a doctor to be able to talk with parents. Establishing a fetal telediagnosis system is a useful strategy to improve neonatal care through a medical link between local maternity hospitals and a tertiary center.
authors.affiliation: Department of Cardiology, Saitama Children's Medical Center, Magome 2100, Iwatsuki-ku, Saitama-shi, Saitama, 339-8551, Japan, hishitani.takashi@pref.saitama.lg.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hishitani
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Saito
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Hoshino
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ogawa
mesh_terms: D000293:Adolescent; D000328:Adult; D004452:Echocardiography / Q000379:methods* / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D005318:Fetal Heart / Q000000981:diagnostic imaging*; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging*; D006771:Hospitals, Maternity / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007564:Japan; D008875:Middle Aged; D010045:Outpatients; D011247:Pregnancy; D019114:Remote Consultation / Q000379:methods* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D016216:Ultrasonography, Prenatal / Q000379:methods* / Q000706:statistics & numerical data; D055815:Young Adult