Telemedicine Based Ultrasound for Detecting Neonatal Heart Disease in Babies at Remote Military of Native American Health Care Facilities

摘要

Our partnership of investigators from Madigan Army Medical Center at Fort Lewis, Washington, and Oregon Health & Science University in Portland, will test the hypothesis that trained primary care practitioners or nurses can, with telemedicine supervision, perform cardiac ultrasound exams on neonates at risk for heart disease, and thereby impact time to diagnosis and outcomes. This study is targeted at Military Medical Facilities within TRICARE West and Western Regional Medial Command. It will also include two large Alaska Native Health Care Centers. Echocardiography has had major impact in the management of neonates suspected of having congenital heart disease. The expensive, specialized equipment and significant expertise to adequately perform and interpret these studies usually is present only in tertiary level medical centers with a pediatric cardiologist on staff. Initial results of a National Multicenter Neonatal Telemedicine Echo Outcomes Study, developed by the Principal Investigator, suggest that telemedicine-implemented diagnosis positively affects outcomes in infants suspected of having congenital heart disease. As an added impact of our program, we will develop expertise within caregivers who have previously not been able to perform these necessary exams, and will integrate the use of low-cost, yet high-performance hand- held ultrasound scanners, so as to provide the participating centers with new diagnostic health care capabilities.