Implementation of a statewide, multisite fetal tele-echocardiography program: evaluation of more than 1100 fetuses over 9 years

Bolin, Elijah H.; Collins, R. Thomas; Best, Thomas H.; Zakaria, Dala; Lang, Sean M.; Boushka, Matthew G.; Renno, Markus S.; Heil, Lori L.; Lowery, Curtis L.; Bornemeier, Renee A.

doi:10.1038/s41372-020-0677-2

Cited by 8 publications

(6 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…32 A testable intervention is telemedicine, which has applications in remote ultrasonography, where a local ultrasonographer performs real-time fetal echocardiograms with the virtual guidance of a pediatric cardiologist, 33 as well as remote counseling for CHDs. 34,35 Telemedicine has demonstrated success in increasing prenatal diagnosis rates for states with a single CHD surgical center. 36,37 Conversely, telemedicine could exacerbate disparities due to a patient's lack of broadband Internet access or insufficient privacy.…”

Section: Discussionmentioning

confidence: 99%

“…Finding solutions for both barriers first requires understanding whether there is (1) a sufficient supply and (2) an efficient distribution of maternal‐fetal medicine subspecialists and fetal cardiologists to meet demand 32 . A testable intervention is telemedicine, which has applications in remote ultrasonography, where a local ultrasonographer performs real‐time fetal echocardiograms with the virtual guidance of a pediatric cardiologist, 33 as well as remote counseling for CHDs 34,35 . Telemedicine has demonstrated success in increasing prenatal diagnosis rates for states with a single CHD surgical center 36,37 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Patient‐reported barriers to prenatal diagnosis of congenital heart defects: A mixed‐methods study

Woo,

Burton,

Iyengar

et al. 2023

Prenatal Diagnosis

View full text Add to dashboard Cite

ObjectiveTo ascertain patient‐reported, modifiable barriers to prenatal diagnosis of congenital heart defects (CHDs).MethodsThis was a mixed‐methods study among caretakers of infants who received congenital heart surgery from 2019 to 2020 in the Chicagoland area. Quantitative variables measuring sociodemographic characteristics and prenatal care utilization, and qualitative data pertaining to patient‐reported barriers to prenatal diagnosis were collected from electronic health records and semi‐structured phone surveys. Thematic analysis was performed using a convergent parallel approach.ResultsIn total, 160 caretakers completed the survey, 438 were eligible for survey, and 49 (31%) received prenatal care during the COVID‐19 pandemic. When comparing respondents and non‐respondents, there was a lower prevalence of maternal Hispanic ethnicity and a higher prevalence of non‐English/Spanish‐speaking households. Of all respondents, 34% reported an undetected CHD on ultrasound or echocardiogram, while 79% reported at least one barrier to prenatal diagnosis related to social determinants of health. Among those social barriers, the most common were difficulty with appointment scheduling (n = 12, 9.5%), far distance to care/lack of access to transportation (n = 12, 9.5%) and difficulty getting time off work to attend appointments (n = 6, 4.8%). The latter two barriers were correlated.ConclusionWhile technical improvements in the detection of CHDs remain an important area of research, it is equally critical to produce evidence for interventions that mitigate barriers to prenatal diagnosis due to social determinants of health.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patient‐reported barriers to prenatal diagnosis of congenital heart defects: A mixed‐methods study

Woo,

Burton,

Iyengar

et al. 2023

Prenatal Diagnosis

View full text Add to dashboard Cite

show abstract

“…While our fetal tele‐echo program was associated with increased prenatal diagnosis rates for families in Kentucky, the details of any successful approach in other locations will likely be based on local teams and infrastructure. We read the recent review of the fetal tele‐echo program from Arkansas Children's Hospital with great interest, both to see the effectiveness of their program and also to compare and contrast their approach in Little Rock to ours in Louisville 6 …”

Section: Discussion Sectionmentioning

confidence: 99%

“…While our fetal tele-echo program was associated with increased prenatal diagnosis rates for families in Kentucky, the details of any successful approach in other locations will likely be based on local both to see the effectiveness of their program and also to compare and contrast their approach in Little Rock to ours in Louisville. 6 Kentucky and Arkansas both share challenges with respect to poverty and geographical isolation in the regions that we serve and the known increased risk for missed prenatal diagnosis of heart defects associated with both. 23 In 2010, when we were looking for ways to improve the rate of prenatal diagnosis of heart defects in our region from an unacceptably low level of 14%, we chose to build on our existing infrastructure and began to identify hospital partners in local communities.…”

Section: Discussion Sectionmentioning

confidence: 99%

Use of fetal tele‐echo at small regional hospitals increases the rate of prenatal diagnosis of congenital heart disease

2022

View full text Add to dashboard Cite

show abstract

“…As a useful protocol for investigating cardiac pathophysiology on remotely-located patients, tele-echocardiography has been widely used in developed countries. [24][25][26][27][28] In China, teleechocardiography has not been implemented into the daily clinical practice yet. The off-line RC-B-TTE used in this study had a time delay and did not benefit the COVID-19 patients involved.…”

Section: Limitations and Perspectivesmentioning

confidence: 99%

Using remote consultation to enhance diagnostic accuracy of bedside transthoracic echocardiography during COVID‐19 pandemic

Lin

Yin

et al. 2021

Echocardiography

View full text Add to dashboard Cite

Objective The aim of this study was to evaluate the clinical significance of remote consultation over bedside transthoracic echocardiography (RC‐B‐TTE) for patients with coronavirus disease 2019 (COVID‐19). Methods Five frontline echocardiographers performed and interpreted B‐TTE for 30 patients with COVID‐19 in the isolation wards, and the on‐site B‐TTE reports (OSR) were generated. Then remote consultation over the 30 B‐TTE studies was conducted by two experienced echocardiographic consultants while blinded to the OSR, and the corresponding remote consultation reports (RCR) were generated. Subsequently, the five frontline echocardiographers were convened together to discuss the difference between the OSR and RCR, and to confirm the correct interpretation and the misdiagnosis using a “majority‐vote” consensus as the diagnostic “gold standard”. Afterwards the reasons for the misdiagnosis were given by the frontline echocardiographers themselves. The inter‐rater agreement between the OSR and the “gold standard” was assessed using Kappa coefficient and percent agreement. Results Complete correctness of the 30 copies of the RCR were determined by the 5 frontline echocardiographers. The reliability of the OSR in the findings of cardiac chamber dilation, left ventricular hypertrophy and pulmonary hypertension were weak ( Kappa <0.6). The reliability of the OSR in the recognition of major cardiac abnormalities was very weak ( Kappa =0.304, percent agreement =63.3%). Misdiagnosis of major abnormalities was found in 11 copies of OSR (11/30, 36.7%). Conclusions The protocol of RC‐B‐TTE has shown noticeable superiority in ameliorating diagnostic accuracy of echocardiography, which should be generalized to clinical practice during the COVID‐19 or similar pandemic.

show abstract

Implementation of a statewide, multisite fetal tele-echocardiography program: evaluation of more than 1100 fetuses over 9 years

Cited by 8 publications

References 42 publications

Patient‐reported barriers to prenatal diagnosis of congenital heart defects: A mixed‐methods study

Patient‐reported barriers to prenatal diagnosis of congenital heart defects: A mixed‐methods study

Use of fetal tele‐echo at small regional hospitals increases the rate of prenatal diagnosis of congenital heart disease

Using remote consultation to enhance diagnostic accuracy of bedside transthoracic echocardiography during COVID‐19 pandemic

Contact Info

Product

Resources

About