一种促进医院服务与社区基层医疗之间整合的儿科远程心脏病学系统。

Mannarino Savina, Calcaterra Valeria, Fini Giulia, Foppiani Andrea, Sanzo Antonio, Pisarra Martina, Infante Gabriele, Marsilio Marta, Raso Irene, Santacesaria Sara, Zuccotti Gianvincenzo

Pediatric Cardiology Unit, Buzzi Children's Hospital, 20154 Milan, Italy.

Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy; Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy.

Int J Med Inform. 2024 Jan;181:105298. doi: 10.1016/j.ijmedinf.2023.105298. Epub 2023 Nov 13.

INTRODUCTION

Telecardiology has emerged as a vital field within telemedicine, fostering collaboration between hospital and community medicine. This pilot study introduces an innovative pediatric telecardiology system, comprising a telecardiology system seamlessly integrated with a hospital telemedicine platform. A smooth flow of ECG execution, transmission, and reporting between Primary Care Pediatrician clinics and the hospital was tested as the primary objective. User experience surveys were also considered.

METHODS

The study involved three Primary Care Pediatrician clinics, and the enrollment of children took place consecutively from January to July 2023. We integrated a digital electrocardiographic signal acquisition unit and online information transmission-capable tablets, that were provided to the pediatricians, with a telemedicine multitenant platform that facilitated the transmission of the patient's ECG data from the community to the Hospital Pediatric Cardiologist.

RESULTS

A total of 158 children (80 M/78F, 8.9 ± 2.8 yrs) underwent ECG recording (78.5 % medical certificates, 21.5 % presence of symptoms) The transmission and reporting of ECGs were successfully completed in all cases, without technical issues. Normal findings on the ECG were demonstrated in 94.9 % of children. 70.8 % of respondents completed all parts of the survey. Respondents had a high level of education (90 %) and demonstrated excellent or good competence in using digital technologies (89 %). 51 % of respondents were not familiar with the term "Telemedicine" and 81 % of the cases had no previous telemedicine experience. 90 % of users were very satisfied or satisfied with the service. Connection problems (2.8 %) and concerns about the service's reliability compared to standard care (3.7 %) were mentioned as possible limitations of the telecardiology.

CONCLUSIONS

Our pediatric telecardiology system offers a valuable diagnostic tool to enhance patient management in the community.

引言

远程心脏病学已成为远程医疗中的一个重要领域，促进了医院医学与社区医学之间的合作。这项试点研究引入了一种创新的儿科远程心脏病学系统，该系统由一个与医院远程医疗平台无缝集成的远程心脏病学系统组成。本研究的主要目的是测试基层儿科医生诊所与医院之间心电图（ECG）执行、传输和报告的顺畅流程。同时也考虑了用户体验调查。

方法

该研究涉及三个基层儿科医生诊所，2023年1月至7月连续招募儿童。我们将数字心电图信号采集单元和具备在线信息传输功能的平板电脑（提供给儿科医生）与一个远程医疗多租户平台集成，该平台便于将患者的心电图数据从社区传输至医院儿科心脏病专家。

结果

共有158名儿童（80名男性/78名女性，8.9±2.8岁）接受了心电图记录（78.5%有医学证明，21.5%有症状）。所有病例的心电图传输和报告均成功完成，无技术问题。94.9%的儿童心电图检查结果正常。70.8%的受访者完成了调查问卷的所有部分。受访者受教育程度较高（90%），在使用数字技术方面表现出优秀或良好的能力（89%）。51%的受访者不熟悉“远程医疗”一词，81%的病例此前没有远程医疗经验。90%的用户对该服务非常满意或满意。连接问题（2.8%）以及与标准护理相比对服务可靠性的担忧（3.7%）被提及为远程心脏病学可能存在的局限性。