title: Robot-assisted remote echocardiographic examination and teleconsultation: a randomized comparison of time to diagnosis with standard of care referral approach.
abstract: The strategy using cardiological consultation in addition to the robot-assisted remote echocardiography at a distance was tested in a prospective, randomized open-label trial to evaluate its feasibility and to define its clinical value in a rural area. The present study involved 1 primary healthcare center in the north of Sweden, 135 miles from the hospital where the echocardiograms and the cardiology teleconsultation were performed long distance in real time. Nineteen patients were randomized to remote consultation and imaging, and 19 to the standard of care consultation. The total process time was significantly reduced in the former arm (median 114 days vs. 26.5 days; p < 0.001). The time from randomization until attaining a specialist consultation was also significantly reduced (p < 0.001). The patients' satisfaction was reassuring; they considered that the remote consultation strategy offered an increased rapidity of diagnosis and the likelihood of receiving faster management compared with the standard of care at the primary healthcare center.
authors.affiliation: Research Unit, Department of Medicine, Skellefteå, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. Electronic address: kurt.boman@vll.se.
authors.forename: Kurt
authors.initials: K
authors.lastname: Boman
authors.affiliation: Research Unit, Department of Medicine, Skellefteå, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Mona
authors.initials: M
authors.lastname: Olofsson
authors.affiliation: Primary Health Care Center, Storuman, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Berggren
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Partho P
authors.initials: PP
authors.lastname: Sengupta
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Jagat
authors.initials: J
authors.lastname: Narula
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care; D015150:Echocardiography, Doppler; D005240:Feasibility Studies; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D019114:Remote Consultation / Q000379:methods*; D012371:Robotics; D019035:Rural Health Services; D013548:Sweden; D013997:Time Factors
keywords: real-time; remote consultation; remote-echocardiography; robot-assisted; telemedicine