Tele-echocardiography in neonates: utility and benefits in South Dakota primary care hospitals

Abstract

Background: Live transmission of echocardiography can provide a rapid and accurate diagnosis in identifying neonates who need emergent transfer to a tertiary care center. This prevents a delay in management and/or unnecessary transport.

Objective: The purpose of this study was to review the utility, accuracy, and benefits of tele-echocardiography in primary care hospitals in South Dakota to assess neonates with suspected congenital heart disease.

Method: Two primary care hospitals established a telemedicine link to our tertiary care center. A pediatric cardiologist interpreted neonatal tele-echocardiograms and results with recommendations were immediately communicated to the attending physicians.

Results: Seventy-six neonatal studies were performed over 30 months, 72 at the primary care sites and 4 at the tertiary care center. Cardiac diagnosis was identified in 30 patients (40%). Neonatal transport was deemed necessary in 8 patients (11%), 5 with major cardiovascular disease and 3 with persistent pulmonary hypertension of the newborn. Two pre-term infants at the tertiary center were diagnosed with patent ductus arteriosus and required medical intervention.

Conclusion: Tele-echocardiography accurately distinguished neonates who required tertiary cardiac care from those with less critical cardiac disease fostering prompt diagnosis and appropriate care while subjecting a minimal number of patients to costly emergency transport.