title: Remote delivery of congenital cardiac magnetic resonance imaging services: a unique telemedicine model.
abstract: Cardiac magnetic resonance imaging (CMRI) is increasingly utilized in the management of patients with congenital heart disease. Unfortunately, the expertise to perform and interpret these studies is not universally available, despite an increasing population of congenital heart survivors. This retrospective analysis describes our experience providing on-site CMRI services compared with providing the same services over a geographic distance of 250 miles. There were 83 local scans with both physician and patient on-site compared with 91 scans controlled by a physician geographically remote from the patients. The patients were well-matched for age, sex, study duration, scan type, and history of prior cardiac intervention. There was no difference in use of deep sedation or diazepam for anxiolysis, or use of atropine for arrhythmia suppression. There were no patient safety issues and there was satisfaction on the part of the referring physicians who were able to obtain more timely studies, as well as the remote-scanning physicians who had a workflow comparable with the local scans, but no lost travel time. This experience suggests that remote delivery of cardiac MRI services for the congenital heart population is feasible and can be done with comparable success and safety to a traditional "local" model. We also suggest the configuration to provide such remote CMRI services with commercially available hardware and software.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics and The Heart Institute, Cedars Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3600, Los Angeles, CA, 90048, USA, Ruchira.garg@cshs.org.
authors.forename: Ruchira
authors.initials: R
authors.lastname: Garg
authors.forename: Arnel
authors.initials: A
authors.lastname: Sevilla
authors.forename: Ross
authors.initials: R
authors.lastname: Garberich
authors.forename: Craig E
authors.initials: CE
authors.lastname: Fleishman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D019112:Teleradiology / Q000458:organization & administration*
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