Assess The Usageof Tele-Cardiology Platform

P. K. Naidu, S. Maheshwari, D. Krishnamurthy, S. Kumar

Burden of Cardiovascular Disease

• Cardiovascular Disease (CVD) is the Number One cause of death worldwide

• 80% of CVD deaths take place in Low-and Middle-income Countries (LMICs)

• People in LMICs who suffer from CVDs have less access to effective and equitable healthcare,which results in late detection during the course of disease and usually die young.

Shortage in Cardia

United States European Union

50-70 50

Recommendation for General Cardiologist /million population.

India – Total Number of qualified cardiologists - <4000(judged by Cardiological society of India). A huge shortage in Cardiologists.

Aims and ObjectivesEvaluate the Effectiveness of a Telecardiology Platform for

• Tele-ECG • Tele-Echocardiography • Tele-Consultation

• Web based Telecardiology platform CARDIOSpa was tested within a clinic in Bangalore and remotely with clinics in Assam, Uttar Pradesh and Karnataka states in India.

• CARDIOSpa uses secure connection in transmitting Echocardiography and other cardiac diagnostic images and is Health Insurance Portability and Accountability (HIPAA) complaint.

Materials and Methods

Tele-ECG Reporting

• In Assam and Uttar Pradesh – Patient walks in for a cardiac evaluation.

• Trained health professional/technician conducts the ECG on the patient.

• ECG images are attached to CARDIOSpa using the easy to use workflow.

• The Cardiologist gets a notification and can view the ECG with a secured login and

report it quickly .

• Pre-installed macros helps in easy reporting and quick sign offs.

• Telemedicine centre gets access to print the report.

Tele-EchocardiographyReporting's Using CARDIOSpa.

• Sonographer performs echo at the clinic according to CARDIOSpa’s imaging protocol.

• On completion, the study automatically gets transferred to CARDIOSpa platform.

• Sonographer completes his provisional report and assigns it to the cardiologist in the panel

• Cardiologist downloads the images in CARDIOSpa Dicom and reviews it with adequate resolution. The provisional sonographers report is correlated and a final diagnosis and report is generated.

• The clinic prints the echo report to hand it over to the patient

Tele-ConsultationA Nurse in the telemedicine centre places the Digital stethoscope on the patients chest. The Cardiologists can hear the patients heart beat and murmurs if any from his end remotely

Limitations• The Quality of sounds from the Digital stethoscope varied due to low

bandwidth at the remote centre .Another reason being loud background noise at these centres.

• In patients with poor echo windows diagnosis was limited.

• Reporting time was delayed in some cases due unavailability of personal

ResultsFrom Jan –July – 2015

• Tele-Echoes : 1278 cases reported for Bangalore clinic with adequate resolution.

• Tele-ECGs : 316 cases reported for Assam and Uttarpradesh Telemedicine centre.

• Tele- Consultation : 7 successful Consults

Suspected MI10%

Bundle Branch Block4.7%

Others (AF,FVR,SVT etc.)1.8%

TOTAL POSITIVE TELE-ECG`S IN 316

76 %Adult TTE

24%Pediatric TTE

Total Tele-Echoes reported by Pediatric and Adult Cardiologist

ConclusionTrained Cardiac Sonographers and ECG technicians can play a significant role using Tele-cardiology in diagnosis of heart disease at earlier stage/follow up in remote clinics where accessibility and availability of cardiologists /cardiac centres are difficult.