The Application of Telehealth in Pediatric Cardiology

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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 Childrens Medical Center

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Incidence of Congenital Heart Disease

• For every 1000 infants born in the United States,
  8 have heart defects.
• Over 85 of these infants are expected to reach
  adulthood if they receive appropriate medical
  attention.

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Management of Congenital Heart Disease

• It has only been possible in the past 60 years to
  identify and treat congenital heart defects in
  infants and children.
• There are approximately 1,521 board certified
  pediatric cardiologists and 244 pediatric
  cardiovascular surgeons practicing in the United
  States (2006 AHA census).
• 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.

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Interventional Heart Catherization

• Interventional procedures
• balloon septostomy and valvuloplasty (PS, AS,
  Coarctation)
• coil embolization (PDA, collaterals)
• Stents
• ASD VSD closure

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Stage I Norwood
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Stage II Norwood (Glenn)
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Stage III Norwood (Fontan)
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Ventricular Tachycardia
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Arrhythmias

• Mapping
• Ablations

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Benefits of Telemedicine in Pediatric Cardiology

• Allows the detection of patients with congenital
  heart disease (particularly important in the
  neonatal period)
• 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).

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Benefits of Telemedicine in Pediatric Cardiology

• Allows efficient use of valuable resources
• Decreased need for hospital to hospital
  transports (patients can stay locally)
• Minimizes duplication of services
• Subspecialty physicians can simultaneously serve
  patients in underserved regions

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Benefits of Telemedicine in Pediatric Cardiology

• Financially beneficial solution
• Line maintenance fees can be shared
• Acceptable initial start-up costs
• Referring institutions can bill for the technical
  component of charges and additional telemedicine
  charge
• Service institution can bill for professional
  component of charges
• Profitable for service institution!

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Telemedicine at the UT/LeBonheur Pediatric
Cardiovascular Institute

• Volume of telecho from representative sites
• Studies performed in a 6 month period
  (January-June 2007)
• JMCGH (Jackson TN)560
• NMMC (Tupelo MS) 417
• Volunteer Hospital (Martin TN)60

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Thank you