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Implanting telehealth network for paediatric cardiology: learning from the Quebec experience

Published online by Cambridge University Press:  21 January 2005

Marc Bellavance
Affiliation:
Département de Pédiatrie, Centre Hospitalier Universitaire de Sherbrooke, Fleurimont, QC, Canada
Marie J. Béland
Affiliation:
Division of Paediatric Cardiology, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, QC, Canada
Nicolaas H. van Doesburg
Affiliation:
Département de Cardiologie, Hôpital Ste-Justine, Université de Montréal, Montreal, QC, Canada
Marc Paquet
Affiliation:
Département de Pédiatrie, Centre Hospitalier Universitaire de Sherbrooke, Fleurimont, QC, Canada
Francine M. Ducharme
Affiliation:
Department of Pediatrics, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, QC, Canada
Alain Cloutier
Affiliation:
Département de Pédiatrie, Service de Cardiologie, Centre Hospitalier de l'Université Laval du Centre Hospitalier Universitaire de Québec, Ste-Foy, QC, Canada

Abstract

The implementation committee of the Quebec Child Telehealth Network was formed in 1997, with a mandate to build a network dedicated to the diagnosis of congenital cardiac disease via telemedicine. We devised criterions for selection to determine which peripheral centres would be linked by telemedicine to the university-based services for paediatric cardiology provided in the Canadian Province of Quebec. The criterions included: distance from a university centre, number of births per year, and presence of an already-established outreach clinic for paediatric cardiology. The Quebec Network became operational in 2000, and was composed of 32 peripheral centres and 4 university centres. A total of 363 transmissions of echocardiograms occurred over a 3-year period from January 2000 to December 2002. Peripheral centres located at a distance greater than 100 kilometres from a university centre were 8.5 times more likely to use the network. Criterions other than distance did not influence whether or not a peripheral centre used the network. Cardiac abnormalities were identified in almost two-thirds of the transmissions. The use of the Quebec Network resulted in the avoidance of transfers or clinic visits to university hospitals in seven-tenths of cases. We conclude that distance greater than 100 kilometres from a centre offering subspecialty services in paediatric cardiology is the most important criterion for choosing the peripheral centres that are most likely to use a telehealth network. In its first three years of operation, the telehealth network had a major impact on the delivery of paediatric cardiac care, improving access to subspecialty services across the province.

Type
Original Article
Copyright
© 2004 Cambridge University Press

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