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The Application of Telehealth in Pediatric Cardiology


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The Application of Telehealth in Pediatric Cardiology

  1. 1. The Application of Telehealth in Pediatric Cardiology Thomas K. Chin, MD FAAP, FACC Director of Pediatric Cardiology and the Pediatric Cardiovascular Institute University of Tennessee College of Medicine and LeBonheur Children’s Medical Center
  2. 2. Incidence of Congenital Heart Disease: <ul><li>For every 1000 infants born in the United States, 8 have heart defects. </li></ul><ul><li>Over 85% of these infants are expected to reach adulthood if they receive appropriate medical attention. </li></ul>
  3. 3. Management of Congenital Heart Disease: <ul><li>It has only been possible in the past 60 years to identify and treat congenital heart defects in infants and children. </li></ul><ul><li>There are approximately 1,521 board certified pediatric cardiologists and 244 pediatric cardiovascular surgeons practicing in the United States (2006 AHA census). </li></ul><ul><li>To obtain accepted standards for outcomes, it is necessary to obtain treatment at a medical center with the facilities and expertise to provide specialized care. </li></ul>
  4. 7. Interventional Heart Catherization: <ul><li>Interventional procedures: </li></ul><ul><ul><li>balloon septostomy and valvuloplasty (PS, AS, Coarctation) </li></ul></ul><ul><ul><li>coil embolization (PDA, collaterals) </li></ul></ul><ul><ul><li>Stents </li></ul></ul><ul><ul><li>ASD& VSD closure </li></ul></ul>
  5. 10. “ Stage I” Norwood
  6. 11. “ Stage II” Norwood (Glenn)
  7. 12. “ Stage III” Norwood (Fontan)
  8. 14. Ventricular Tachycardia
  9. 15. Arrhythmias: <ul><li>Mapping </li></ul><ul><li>Ablations </li></ul>
  10. 17. Benefits of Telemedicine in Pediatric Cardiology <ul><li>Allows the detection of patients with congenital heart disease (particularly important in the neonatal period) </li></ul><ul><li>Allows access for regional hospitals and the patients they serve to the expertise of a major medical center (services would otherwise be unavailable to these patients). </li></ul>
  11. 18. Benefits of Telemedicine in Pediatric Cardiology <ul><li>Allows efficient use of valuable resources: </li></ul><ul><ul><li>Decreased need for hospital to hospital transports (patients can stay locally) </li></ul></ul><ul><ul><li>Minimizes duplication of services </li></ul></ul><ul><ul><li>Subspecialty physicians can simultaneously serve patients in underserved regions </li></ul></ul>
  12. 19. Benefits of Telemedicine in Pediatric Cardiology <ul><li>Financially beneficial solution </li></ul><ul><ul><li>Line maintenance fees can be shared </li></ul></ul><ul><ul><li>Acceptable initial start-up costs </li></ul></ul><ul><ul><li>Referring institutions can bill for the technical component of charges and additional telemedicine charge </li></ul></ul><ul><ul><li>Service institution can bill for professional component of charges </li></ul></ul><ul><ul><li>Profitable for service institution! </li></ul></ul>
  13. 20. Telemedicine at the UT/LeBonheur Pediatric Cardiovascular Institute <ul><li>Volume of telecho from representative sites: </li></ul><ul><li>Studies performed in a 6 month period (January-June 2007) </li></ul><ul><li>JMCGH (Jackson TN)—560 </li></ul><ul><li>NMMC (Tupelo MS) –417 </li></ul><ul><li>Volunteer Hospital (Martin TN)–60 </li></ul>
  14. 21. Thank you