Hishitani Takashi, Fujimoto Yoshitaka, Saito Yukinori, Sugamoto Kenji, Hoshino Kenji, Ogawa Kiyoshi
Department of Cardiology, Saitama Children's Medical Center, Magome 2100, Iwatsuki-ku, Saitama-shi, Saitama, 339-8551, Japan,
Pediatr Cardiol. 2014 Apr;35(4):652-7. doi: 10.1007/s00246-013-0834-x. Epub 2013 Nov 21.
Information and communication technology has been widely applied to various fields, including clinical medicine. We report here a telediagnosis system using ultrasound image transmission. The effect of telediagnosis, using a medical link between local maternity hospitals and our children's medical center, was verified. The number of fetal telediagnosis for cardiac disease, and cases referred to a perinatal care center and emergent transportation of neonates with congenital heart disease from maternity hospitals, were calculated based on the hospital records. The percentage of patients found to have heart disease was compared between out-patient clinic and telediagnosis cases. Telediagnosis increased, allowing maternity hospital staff to obtain support easily from a specialist when making a diagnosis. Many severe cases were transferred to tertiary centers with the correct diagnosis; consequently, the number of emergent transportations of neonates with severe cardiac anomalies continued to below. Telediagnosis was also useful as an educational tool for maternity hospital staff, who improved their skills during conversations with a specialist. Unlike in the outpatient clinic, consultation by telediagnosis was requested even for cases of mild abnormalities, and the number of false-positives increased, while many cardiac anomalies were found in the early stage. Furthermore, telediagnosis was helpful for pregnant women requiring bed rest, and also had the advantage of allowing a doctor to be able to talk with parents. Establishing a fetal telediagnosis system is a useful strategy to improve neonatal care through a medical link between local maternity hospitals and a tertiary center.
信息通信技术已广泛应用于包括临床医学在内的各个领域。我们在此报告一种使用超声图像传输的远程诊断系统。通过当地妇产医院与我们儿童医疗中心之间的医疗联系，验证了远程诊断的效果。根据医院记录，计算了胎儿心脏病远程诊断的数量、转诊至围产期护理中心的病例数以及妇产医院先天性心脏病新生儿的紧急转运情况。比较了门诊病例和远程诊断病例中被发现患有心脏病的患者百分比。远程诊断增加了，使妇产医院工作人员在进行诊断时能够轻松获得专家支持。许多重症病例在得到正确诊断后被转至三级中心；因此，患有严重心脏畸形的新生儿的紧急转运数量持续下降。远程诊断对妇产医院工作人员也是一种有用的教育工具，他们在与专家交谈过程中提高了技能。与门诊不同，即使是轻度异常病例也会要求进行远程诊断咨询，假阳性数量增加，同时许多心脏畸形在早期就被发现。此外，远程诊断对需要卧床休息的孕妇有帮助，并且还有让医生能够与家长交谈的优势。建立胎儿远程诊断系统是通过当地妇产医院与三级中心之间的医疗联系来改善新生儿护理的一项有用策略。
