American Society of Echocardiography: Remote Echocardiography with Web-Based Assessments for Referrals at a Distance (ASE-REWARD) Study

Singh, S.; Bansal, Manish; Maheshwari, Puneet; Adams, David B.; Sengupta, Shantanu; Price, Rosemary J. G.; Dantin, LeaAnne; Smith, Mark F.; Kasliwal, Ravi R; Pellikka, Patricia A.; Thomas, James D.; Narula, Jagat; Sengupta, Partho P.

doi:10.1016/j.echo.2012.12.012

Cited by 97 publications

(73 citation statements)

References 35 publications

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“…Cloud servers are enabling echocardiograms to be transmitted and accessed from anywhere in the world. 55,56 This expansion of technology mandates a need for diligent attention to security and a dramatic increase in dependence on technical support staff.…”

Section: Evolution Of the Technologymentioning

confidence: 99%

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Satou¹,

Rheuban²,

Alverson³

et al. 2017

Circulation

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A dvancements in technology and broadband have revolutionized the current practice of medicine. The field of pediatric cardiology is no exception given the need for prompt diagnosis and reliance on cardiac imaging to identify infants and children with potentially life-threatening cardiovascular disease. As the relationship between telemedicine and pediatric cardiology has advanced, it has created a need to develop a broad, comprehensive document reviewing all the various aspects of telemedicine in pediatric cardiology. For more than a decade, a significant body of literature has been published describing individual experiences and practices, yet there remains no comprehensive statement or document summarizing this rapidly advancing field. In an effort to describe the collective experience and to provide structure and guidance for pediatric cardiology practitioners and healthcare providers, we have developed a scientific statement on the use of telemedicine in pediatric cardiology.Specific areas explored in this document include both neonatal and fetal teleechocardiography, implications for training community sonographers, pulse oximetry programs, qualitative improvement and appropriate use criteria initiatives, and remote electrophysiological monitoring. This document also includes teleconsultation and teleausculation, direct-to-consumer and home monitoring programs, and a look into the use of telemedicine and pediatric cardiology in the intensive care setting. Furthermore, a detailed review of the legislative, public policy, and legal aspects of telemedicine is provided, along with financial and reimbursement information.Several terms are used in the literature interchangeably; a brief explanation is provided to help readers of this document. The term telehealth is defined as the use of technology to bridge distances in any aspect of medicine; telemedicine is the specific application of technology to conduct clinical medicine at a distance. The term telecardiology is defined as the broad application of telemedicine in the field of cardiology specifically, and tele-echocardiography is the most common application used within this field. ECHOCARDIOGRAPHY AND TELEMEDICINEEchocardiography is the most commonly used noninvasive cardiovascular imaging modality and is considered to be both safe and cost-effective. Tele-echocardiography can be described as a process in which a provider or a technician obtains cardiovascular ultrasound images from a given patient and these images are subsequently transmitted to an offsite location where a cardiologist can provide further analysis and interpretation. Thus, tele-echocardiography enables expert interpretation and consultation in a rapid and potentially geographically disparate fashion, enabling prompt and accurate decision making involving triage, transport, and therapeutic priorities. Tele-echocardiography is now routinely used across the age and subspecialty spectrum in pediatric cardiology.

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Section: Evolution Of the Technologymentioning

confidence: 99%

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Satou¹,

Rheuban²,

Alverson³

et al. 2017

Circulation

View full text Add to dashboard Cite

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“…Of 1,021 interpretable scans, 20.3 % had minor and 16.7 % had major abnormalities. There was excellent agreement in assessing valvular lesions [67].…”

Section: Technology Considerations and Telemedicinementioning

confidence: 95%

Out of hospital point of care ultrasound: current use models and future directions

Nelson

Sanghvi

2015

Eur J Trauma Emerg Surg

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Prehospital ultrasound has the ability to increase diagnostic ability and allow for therapeutic intervention in the field. In austere environments, ultrasound may be the only available imaging modality and thus can guide diagnosis, therapeutics and determine which patients may need emergent transfer to a healthcare facility. The most cutting edge applications of portable ultrasound employ telemedicine to obtain and transmit ultrasound images. This technology and ability to transmit images via satellite and cellular transmission can allow for even novice users to obtain interpretable images in austere environments. Portable ultrasound uses have steadily grown and will continue to do so with the introduction of more portable and durable technologies. As applications continue to grow, certain technologic considerations and future directions are explored.

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“…Open access and computer-assisted decision-making allow the user to prioritize referral and alleviate unnecessary expenses [29,51,52] . [42,43,47] is defined as an echocardiographic exam performed outside of a medical facility, which translates into a significant cost savings [42] by reducing the cost of services [28].…”

Section: Open Access Echocardiographymentioning

confidence: 99%

“…Immediate on-site test interpretation [6,42,49,53] and automated quality assurance assist appropriate triage [16,34,35,47]. Elective use of web-based physician assistance enhances accuracy and reduces cost [47]. Computer assisted multi-feature systems biology markedly lowers the incidence of false positives, increases access and reproducibility (96%) [43,55,56], lowers cost, and increases efficiencies [9,37,43].…”

Section: Computer Assisted Data Interpretation and Decisionmakingmentioning

confidence: 99%

“…This directive is based on the premise that for a wide range of general prediction problems, easy-to-implement computer-based software is as reliable as and typically more reliable than, human expert interpretation [48][49][50]54]. Immediate on-site test interpretation [6,42,49,53] and automated quality assurance assist appropriate triage [16,34,35,47]. Elective use of web-based physician assistance enhances accuracy and reduces cost [47].…”

Section: Computer Assisted Data Interpretation and Decisionmakingmentioning

confidence: 99%

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Part 3 - Cardiac Death in Athletes Implementation of a High Quality, Low Cost, Pathophysiologic Screening Exam

Paterick¹

2015

JESO

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Open Access Review Articlebecause of the low prevalence of diseased athletes and the large number of false-positive and false negative tests [1,[23][24][25][26][27][28][29]. Both cost and price of a complete echocardiogram is prohibitively high (e.g., $427 Medicare to >$2,275) [30].The cost of a limited echocardiogram is much lower (e.g.,$10 to $75) [24,31,32], but it does not focus upon the essential features pertinent to athletic screening to determine risk [29,32,33]. Small hand held devices have a certain degree of cost effectiveness, [24] but have a high price because this technology currently is incapable of obtaining or quantifying emergent physiologic data.A logical solution to this dilemma is an essential, focused echocardiogram designed to obtain small numbers of related pathophysiologic data [28] and maximize cost-effectiveness [19]. Practice expenses are further reduced by selection of point-ofcare ultrasound, remote exam rooms, limited documentation, cloud storage and reduction of costly services [28]. The cost of a focused echo cannot mirror the cost of a limited echo, CPT (93308), because the components and services used are substantially different. The essential, focused screening emphasizes the essentials of simplicity [15,[34][35][36]:assurance of normal and rule-out of abnormal. [2,5,9,13,28,34,43,45]; and prioritize the confirmation of normal and there-by rule out the rare abnormal [7]. Additional novel efficiencies include open-access ordering High QualityEssential criteria for quality include: eliminate false positives and false negatives [5,7]; prioritize pathophysiology [5,9], causality [10][11][12], simplicity [13][14][15], inductive reasoning [16], and "essentialism" [17,18].

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American Society of Echocardiography: Remote Echocardiography with Web-Based Assessments for Referrals at a Distance (ASE-REWARD) Study

Cited by 97 publications

References 35 publications

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Telemedicine in Pediatric Cardiology: A Scientific Statement From the American Heart Association

Out of hospital point of care ultrasound: current use models and future directions

Part 3 - Cardiac Death in Athletes Implementation of a High Quality, Low Cost, Pathophysiologic Screening Exam

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