VCU uses telemedicine for diagnosis of congenital heart defects

By Melissa Jones

RICHMOND, Va. — Congenital heart disease is one of the leading causes of infant death in the United States. However, specialists trained to diagnosis it are usually only based at major academic medical centers, leaving some areas of the country without nearby expertise. Virginia Commonwealth University is one of a few dozen U.S. medical centers using new technology to provide remote hospitals with quick diagnosis via a virtual link.

"Often, babies with congenital heart defects look normal and healthy after they’re born," said Mary Donofrio, M.D., a pediatric cardiologist at VCU’s Medical College of Virginia Hospitals. "But a few days after going home, these babies can get sick very quickly and even die. When a congenital defect is a possible diagnosis, every minute is crucial. This system means that a diagnosis can be made quickly – so that treatment can begin as soon as possible."

While some hospitals have the equipment to perform an echocardiogram, the test that is usually used to diagnosis a congenital heart defect, they often do not have pediatric cardiologists on staff to evaluate the test results. VCU’s high-tech system, called tele-echo, is designed to provide those hospitals with long-distance access to specialists who can interpret the results.

In use for about 18 months, the tele-echo system uses computer software and high-quality phone lines to connect VCU’s medical center to two other hospitals in the region: Fredericksburg’s Mary Washington Hospital and Richmond’s Bon Secours St. Mary’s Hospital. At low cost, the affiliate hospitals transmit clear, moving images to MCV Hospitals. If the images reveal an obstruction or abnormality, doctors can begin treatment immediately.

More than 120 patients have been seen via the tele-echo system. Though most diagnoses are not severe, the system means a quicker diagnosis for patients with congenital heart defects – sometimes saving hours that could mean the difference between life and death. The new system also eliminated the previous problem of the specialist or patient having to travel between hospitals.

Before tele-echo was available, a video tape of the echocardiogram sometimes was couriered to the specialist – a risky proposition if the specialist received a poor-quality video that was inadequate for making a diagnosis. Because the tele-echo system transmits the echocardiogram in real time, the pediatric cardiologist is able to speak with and instruct the technician performing the echocardiagram. It results in better, more useful images.

"Tele-echo makes it possible for any hospital to have a pediatric cardiologist on site, in a virtual sense," said Donofrio. "Our system has made it possible for parents to get an accurate diagnosis without leaving their neighborhood."

The pediatricians at VCU hope to offer tele-echo to more hospitals in the region. In the future, the doctors’ home computers also will be tied into the system to make evaluation and diagnosis that much faster.

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