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Telecardiology: Effective Means of Delivering Cardiac Care to Rural Children

Department of Pediatrics, Apollo Rural Hospital, Andhra Pradesh, India

For reprint information contact: Prem Sekar, MRCP Tel: 91 44 2656 4224 Fax: 91 44 2656 5150 Email: premsekar{at}yahoo.com, Department of Pediatric Cardiology, International Center for Cardio-Thoracic and Vascular Diseases, R-30-C, Ambattur Industrial Estate Road, Chennai 600 101, India.

Telemedicine allows face-to-face interaction between the medical specialist and the patient. We present our experience of 102 pediatric telecardiology consultations between a tertiary care cardiac center and a remote rural hospital located 120 miles away, between July 2000 and December 2003. The connection was through a Very Small Aperture Terminal satellite bandwidth provided by the Indian Space Research Organization. An S-video link between the echocardiographic and videoconferencing equipment at the remote center allowed the specialist to view images in real time. Pathology was ruled out in 50 (49%) children by tele-echocardiography. Cardiac problems were diagnosed in 52 children (51%), of whom 30 (29%) required surgery. Successful cardiac surgery following telediagnosis was carried out in 18 patients, 8 are awaiting elective operations, and 4 died before surgical correction. The Very Small Aperture Terminal enabled a higher bandwidth that allowed clear images with no significant diagnostic errors. This study demonstrates that pediatric telecardiology effectively delivers cardiac care in rural centers in developing countries with stretched medical resources, where the specialists are urban centered and the majority of patients are rural based.