Prairie Vascular Research Network, University of Saskatchewan, Regina, Saskatchewan, Canada.
Can J Cardiol. 2013 Jul;29(7):873-8. doi: 10.1016/j.cjca.2012.06.016. Epub 2012 Aug 24.
Management of adults with congenital heart disease (ACHD) requires quaternary centres with cardiologists and cardiac surgeons who have expertise in the diagnosis and management of this patient population. We report on the feasibility of the management of ACHD patients using videoconferencing and streaming through 1 regional referral centre covering 4 western Canadian provinces, roughly 30% of Canada's land and population.
Videoconferencing sessions from January 2008 to December 2010 were systematically reviewed. Case presentations were classified as successful or unsuccessful. All patients were followed to assess whether the recommendations were acted upon. The hosting institution used the Alberta Health Services internet protocol network, while other connections used integrated service digital network. The videoconference equipment at the different sites includes Polycom HDX 9000 (Polycom, San Jose, CA), Tandberg Edge 95 (Tandberg, San Jose, CA), and Tandberg 990 (Tandberg).
From January 2008 to December 2010 there were 26 sessions, 213 case presentations, and 177 patients discussed with an average 8.2 case presentations per session. Thirty-two case presentations were deferred, 10 of which were because of transmission errors and the remainder were because of unavailability of staff or images. Of the 177 recommendations, 124 procedures (91 surgical, 29 percutaneous, and 4 electrophysiological) were booked directly at the regional referral centre. Only 6 recommendations were not carried out (4 because of premature deaths, and 2 because of patient logistic issues).
The results of this study illustrate that telehealth is a feasible medium for arriving at consensus recommendation in the management of ACHD patients living in a geographically diverse area.
成人先天性心脏病（ACHD）的管理需要有心脏病专家和心脏外科医生的四级中心，他们具有诊断和管理这类患者人群的专业知识。我们报告了使用视频会议和流媒体通过一个覆盖加拿大西部四个省的区域转诊中心来管理 ACHD 患者的可行性，该中心大约覆盖了加拿大 30%的土地和人口。
系统回顾了 2008 年 1 月至 2010 年 12 月的视频会议记录。将病例介绍分为成功或不成功。所有患者都接受了随访，以评估建议是否得到执行。主持机构使用艾伯塔省卫生服务互联网协议网络，而其他连接使用综合业务数字网络。不同地点的视频会议设备包括 Polycom HDX 9000（Polycom，圣何塞，加利福尼亚州）、Tandberg Edge 95（Tandberg，圣何塞，加利福尼亚州）和 Tandberg 990（Tandberg）。
2008 年 1 月至 2010 年 12 月，共进行了 26 次会议，213 例病例介绍，讨论了 177 例患者，每次会议平均有 8.2 例病例介绍。32 例病例介绍被推迟，其中 10 例是由于传输错误，其余是由于工作人员或图像不可用。在 177 项建议中，有 124 项手术（91 项外科手术，29 项经皮手术和 4 项电生理手术）直接在区域转诊中心预约。只有 6 项建议未执行（4 项是由于过早死亡，2 项是由于患者后勤问题）。
这项研究的结果表明，远程医疗是一种可行的媒介，可以就居住在地理上多样化地区的 ACHD 患者的管理达成共识建议。
