RT Journal Article
SR Electronic
T1 A paediatric telecardiology service for district hospitals in south-east England: an observational study
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 273
OP 277
DO 10.1136/adc.2008.138495
VO 94
IS 4
A1 R Dowie
A1 H Mistry
A1 M Rigby
A1 T A Young
A1 G Weatherburn
A1 G Rowlinson
A1 R C G Franklin
YR 2009
UL http://adc.bmj.com/content/94/4/273.abstract
AB Objectives: To compare caseloads of new patients assessed by paediatric cardiologists face-to-face or during teleconferences, and assess NHS costs for the alternative referral arrangements.Design: Prospective cohort study over 15 months.Setting: Four district hospitals in south-east England and a London paediatric cardiology centre.Patients: Babies and children.Intervention: A telecardiology service introduced alongside outreach clinics.Measurements: Clinical outcomes and mean NHS costs per patient.Results: 266 new patients were studied: 75 had teleconsultations (19 of 42 newborns and 56 of 224 infants and children). Teleconsultation patients generally were younger (49% being under 1 year compared with 32% seen personally (p = 0.025)) and their symptoms were not as severe. A cardiac intervention was undertaken immediately or planned for five telemedicine patients (7%) and 30 conventional patients (16%). However, similar proportions of patients were discharged after being assessed (32% telemedicine and 39% conventional). During scheduled teleconferences the mean duration of time per patient in sessions involving real-time echocardiography was 14.4 min, and 8.5 min in sessions where pre-recorded videos were transmitted. Mean cost comparisons for telemedicine and face-to-face patients over 14-day and 6-month follow-up showed the telecardiology service to be cost neutral for the three hospitals with infrequently-held outreach clinics (£1519 vs £1724 respectively after 14 days).Conclusion: Paediatric cardiology centres with small cadres of specialists are under pressure to cope with ever-expanding caseloads of new patients with suspected anomalies. Innovative use of telecardiology alongside conventional outreach services should suitably, and economically, enhance access to these specialists.