Telemedicine in critical care: collaborative experience in postoperative pediatric cardiac care.

OBJECTIVES

Telehealth applied to the perioperative care of pediatric patients with congenital heart disease facilitates sharing experiences and provides valuable support to institutions initiating cardiac surgery programs, improving the quality of patient care. The primary goal of this study is to describe the implementation and initial results of a collaborative telehealth program between two cardiac centers with different complexity.

METHOD

Three teleconsultations per patient were programed, one preoperative to identify risks and discuss postoperative strategies, the second immediate after admission, and the last on day 2 pop. Demographic data, diagnosis, and surgical procedures (RACHS-1 scale) were recorded. A satisfaction survey was completed at the end of the process for each patient. A descriptive analysis was performed (Stata).

RESULTS

One hundred and twenty-three patients were consulted in 154 connections, with an average of 25 min consultation. Diagnoses included ventricular septal defect, atrial septal defect, and aortic coartation. The proportion of patients undergoing more complex procedures (RACHS-1 ≥ 3) increased from 9.5 to 35%. Survey results indicated that teleconsultation significantly contributed to problem-solving and understanding (100%), suggested new studies (18.6%), or new diagnoses (16.3%), modifications in therapeutic proposals (37.2%), and follow-up protocols (49%). Connectivity issues (41.8%) and challenges in coordinating consultation schedules (42%) were identified as the main difficulties.

CONCLUSIONS

Throughout the program, the complexity of RACHS-1 ≥ 3 procedures increased from 9.5 to 35%. Teleconsultation demonstrated notable enhancements in understanding and problem-solving capabilities, despite challenges in connectivity and scheduling coordination.