Telehealth: the benefits of video conferencing

Medical staff, patients and parents are using a new system that has saved lives

Outpatients who require ongoing monitoring are given a laptop equipped with in-built video conferencing technology.

Every year, more than 200 infants are born in Northern Ireland with heart disease. I work at the Royal Belfast hospital for sick children and as specialists in paediatric cardiology, we deal with a majority of these cases. For the past few years we’ve been supplementing our traditional care with a telemedicine scheme that offers patients, parents and our colleagues a new way to interact.

Like thousands of hospital departments across the UK, we deal with resourcing difficulties. Not only do we cope with our current patient load but our expertise is also in high demand with colleagues at other hospitals.

Another challenge is providing outpatient care to children with complicated heart conditions who still require face time with doctors. Their homes are dispersed across a wide geographical area and these visits can be time consuming for both doctors and patients.

It was these two factors that lead us to try telemedicine.

Nurses, doctors, patients and parents are using it, so reliability, simplicity, and a having a personal interface are all really important. If it’s too hard to use or doesn’t always work people would just get fed up with it.

Outpatients who have recently been discharged but require ongoing monitoring are given a laptop equipped with in-built video conferencing technology. The parents then use this for regular appointments or, if they notice worrying symptoms, to contact the cardiology department

This means we can keep a very close eye on children with complex heart problems who are at risk of deteriorating quickly. We can even visualise data such as their oxygen levels on the screen as we talk over video.

Once you’ve seen the child via video conference, you can usually decide very quickly whether or not that child needs to come back into hospital. Parents appreciate this because it’s a point of contact – a physical image of the consultant right there in their home.

We always advise parents to come in immediately if they feel it is urgent, but many issues can be dealt with remotely.

We use telemedicine for a lot more than just remote monitoring. A programme has been set up that links Clark Clinic (the paediatric cardiology ward) with other hospitals in the region.

If a baby is born in another hospital many miles away, the local paediatrician can now scan the baby’s heart and transmit it to us via video conference, giving doctors at Clark Clinic a chance to provide an expert opinion on the scan images and help make an accurate diagnosis.

Both teams can examine the scans in real time while we go through other symptoms.

For children with heart problems, this is a very important development because making a diagnosis within the first 24 to 48 hours is often crucial to the outcome. Those who really need to come to Clark Clinic can come to us much earlier and those who don’t need to come can have the diagnoses excluded at a very early stage.

There’s no doubt in my mind this has saved lives.

Overall cost savings have definitely outweighed the expenditure of buying the system, but there’s more to it than that. It gives us a chance to share our expertise outside our own hospital.

The value we can add by offering patients and colleagues support like this is incalculable.

Looking forward we want to network with other hospitals and plan to extend connections to other regional hospitals, where there might be paediatric expertise but not in cardiology.

We want to do more with our home monitoring system in terms of its sophistication too. Hopefully, we can add even more physiological monitoring to go along with the laptop that would give us considerably more information about the patient. I’ve no doubt technology will develop even further in this area.

We have already begun some work on this. Children who are at home with a very serious condition and are on home ventilation could also benefit from telemedicine. To bring children in that situation into hospital can be difficult so being able to monitor them remotely can make a huge difference.

Dr Frank Casey is consultant paediatric cardiologist at Clark Clinic in the Royal Belfast hospital for sick children. He has published several academic articles on telemedicine

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