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A paediatric telecardiology service for district hospitals in South-East England: an observational study

Dowie, Robin, Mistry, M., Rigby, M., Young, T., Weatherburn, Gwyn, Rowlinson, G. and Franklin, R.C.G.G. (2009) A paediatric telecardiology service for district hospitals in South-East England: an observational study. Archives of Disease in Childhood, 94. pp. 273-277. ISSN 0003-9888

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Abstract

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.

Item Type: Article
Divisions: ?? BucksNewUniversity ??
Depositing User: ULCC Admin
Date Deposited: 24 Aug 2012 13:09
Last Modified: 11 Dec 2017 19:19
URI: http://bucks.collections.crest.ac.uk/id/eprint/9811

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