The Role of Telemedicine in Paediatric Cardiology

The Role of Telemedicine in Paediatric Cardiology

Brian A. McCrossan (The Royal Belfast Hospital for Sick Children, Northern Ireland) and Frank A. Casey (The Royal Belfast Hospital for Sick Children, Northern Ireland)
Copyright: © 2013 |Pages: 45
DOI: 10.4018/978-1-4666-2979-0.ch004
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Abstract

Paediatric cardiology is a subspecialty ideally suited to telemedicine. A small number of experts cover large geographical areas and the diagnosis of congenital heart defects is largely dependent on the interpretation of medical imaging. Telemedicine has been applied to a number of areas within paediatric cardiology. However, its widespread uptake has been slow and fragmentary. In this chapter the authors examine the current evidence pertaining to telemedicine applied to paediatric cardiology, including their own experience, the importance of research and, in particular, economic evaluation in furthering telemedicine endeavours. Perhaps most importantly, they discuss the issues relating transitioning a pilot project into a sustainable clinical service.
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Background

In order to employ telemedicine technology in a congenital cardiac setting it is essential to understand what paediatric cardiology is, how clinical care is currently provided, what aspects of paediatric cardiology practice are suited to telemedicine and the evidence base.

What is Paediatric Cardiology?

Paediatric cardiology is the medical specialty concerned with diseases of the heart in the growing and developing individual.(Workforce Review Team, 2009) Paediatric cardiologists investigate and treat patients with congenital or acquired heart disease, diseases of cardiac rhythm and conduction, and disturbances of cardiac and circulatory function. The specialty provides a service for acute and chronic conditions from fetal life through childhood into adulthood (National Health Service).

Paediatric cardiology is a demanding and exciting specialty to work in. There have been great advances in paediatric cardiology over the last two decades. Improvements in diagnostic imaging, intensive care, introduction of prostaglandin therapy, catheter procedures and in particular surgical procedures have contributed to dramatically improved outcomes for patients with CHD. In the UK, the national average 1 year survival rate for all operations and catheter intervention is 95%.(Congenital Cardiac Audit Database, 2009) In particular children with complex CHD, typified by single ventricle physiology, now have the possibility of life beyond the neonatal period.(Marino, 2002).

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