Robot-assisted echo exams speed up care for rural patients
A pilot project using robot-assisted echocardiography and videoconferencing chopped months off the time it took for patients with suspected heart failure who lived in rural areas to receive consultations with cardiologists.
Kurt Boman, MD, PhD, of Umea University in Umea, Sweden, and colleagues developed a strategy to provide care for aging patients in remote regions who are in need of advanced diagnostic and management. They designed a randomized study to test the feasibility of providing early diagnosis and treatment for heart failure patients based on teleconsultations and robot-assisted echo exams. Their results were published in the August issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.
The Swedish team enrolled 38 patients in a rural region who had heart failure symptoms and whose general practitioner recommended a consultation with a specialist. Nineteen patients received robot-assisted imaging followed by a videoconference with a cardiologist and sonographer and the patient and his or her general practitioner. The other 19 underwent traditional care.
Their primary aim was to test whether the program shortened the time to diagnosis compared with standard care. The secondary aim focused on the patients’ experience and satisfaction. They defined total time to diagnosis as the period from the first patient encounter with a primary healthcare center to when the general practitioner signed off on a care report form.
Total process time was much shorter with remote consultation, at a median 27 days vs. 114 days. The span between randomization and a consultation with a cardiologist was also much shorter, at a median 12 days vs. 86 days.
When asked about their experiences, 89 percent of the remote consultation group favored the new approach and were comfortable with the robotic echo exam process. All of the patients in the remote consultation group voiced satisfaction with the information they received and 95 percent believed they received faster care compared with the traditional pathway.
“[T]he remote consultation markedly abbreviated the healthcare delivery process and also offered an important clinical education opportunity for the GP [general practitioner],” they wrote.
Boman et al added that the program is designed to help in primary care settings and is not meant to replace echo exams in more complicated clinical situations. They wrote that the next step is to evaluate whether shorter time to diagnosis leads to better outcomes.