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. 2015 Jan;28(1):75-87.
doi: 10.1016/j.echo.2014.09.001. Epub 2014 Oct 8.

Value of interactive scanning for improving the outcome of new-learners in transcontinental tele-echocardiography (VISION-in-Tele-Echo) study

Manish Bansal  1 , Shaanemeet Singh  2 , Puneet Maheshwari  2 , David Adams  3 , Marti L McCulloch  4 , Tanuj Dada  2 , Shantanu P Sengupta  5 , Ravi R Kasliwal  1 , Patricia A Pellikka  6 , Partho P Sengupta  7 ; VISION-in-Tele-Echo Study Investigators
Collaborators, Affiliations

Value of interactive scanning for improving the outcome of new-learners in transcontinental tele-echocardiography (VISION-in-Tele-Echo) study

Manish Bansal et al. J Am Soc Echocardiogr. 2015 Jan.

Abstract

Background: Point-of-care (POC) echocardiography may be helpful for mass triage, but such a strategy requires adequately trained sonographers at the remote site. The aim of this study was to test the feasibility of using a novel POC echocardiography training program for improving physicians' imaging skills during preanesthetic cardiac evaluations performed in a community camp organized for treating cataract blindness.

Methods: Seventeen physicians were provided 6 hours of training in the use of POC echocardiography; nine were taught on site and eight were taught online through a transcontinental tele-echocardiography system. The trained physicians subsequently scanned elderly patients undergoing cataract surgery. The quality of images was graded, and agreement between local physicians' interpretations and Web-based interpretations by worldwide experts was compared.

Results: A total of 968 studies were performed, with 660 used for validating physicians' competence. Major cardiac abnormalities were seen in 136 patients (14.2%), with 32 (3.3%) deemed prohibitive to surgery in unmonitored settings. Although good-quality images were obtained more frequently by physicians trained on site rather than online (P = .03), there were no differences between the two groups in agreement with expert interpretations. The majority of physicians (70.6%) expressed satisfaction with the training (average Likert-type scale score, 4.24 of 5), with no difference seen between the two groups. The training resulted in significant improvements in self-perceived competence in all components of POC echocardiography (P < .001 for all).

Conclusions: This study establishes the feasibility of using short-duration, one-on-one, personalized transcontinental tele-echocardiography education for wider dissemination of echocardiographic skills to local physicians in remote communities, essential for optimizing global cardiovascular health.

Keywords: Focused ultrasound; Tele-echocardiography; Tele-education.

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