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For many patients who live in rural area and have need for specialized medical care, receiving regular and timely visits with a specialist can be an extraordinary and expensive burden. One potential solution to this issue is the use of telemedicine, allowing medical information to be exchanged between medical sites via electronic communications in order to improve a patient’s clinical health status. This innovative approach to medical care began expanding at Children’s Hospital Colorado approximately 4 years ago, with an increasing number of specialties now offering telemedicine care options.
Telemedicine has the potential to save patients time and money, and to decrease the amount of time missed from work to attend screening interventions. Children's Colorado currently conducts a fetal echocardiography telemedicine clinic in collaboration with St. Mary's Medical Center in Grand Junction, CO. This service provides critical access to fetal cardiac care and overcomes the geographic separation between patients and university-based tertiary centers. Pregnant mothers from the western slope are referred to the fetal echocardiography telemedicine clinic at St. Mary's when a concern arises that their unborn baby may have congenital heart disease (CHD). Prenatal diagnosis can increase survival as newborns with congenital heart defects may be clinically unstable at birth. Prior to telemedicine, families had to travel over the mountains to Denver for this service and timely diagnostic information.
We feel certain that our telemedicine program benefits not only patients and their babies but also Children’s Colorado and its partnerships with referring communities. We currently have a research study examining whether tertiary-level diagnosis can be made through 1) telemedicine; 2) patient satisfaction with the service; 3) referring physician satisfaction; 4) impact of the use of telemedicine regarding transfers avoided; 4) cost and time savings comparison for the patient regarding time and travel savings.
We hope that our collaboration with St. Mary’s will inform us about how to better serve mothers who need this screening. The effort has the capacity to be scaled to other interventions that might increase access to care lower costs of care, improved quality of care and improve patient outcomes.
Recognizing CHD before birth can improve both prenatal and postnatal outcomes. Certain pregnancies are known to be at high risk for CHD, yet most cardiac defects occur in low-risk pregnancies. Thus, one way to improve the outcome of fetal CHD is to improve prenatal detection in both high and low-risk pregnancies.
At Children’s Colorado, we offer a unique fetal echocardiography preceptorship program which is a 2-day apprenticeship created for health care providers interested in improving their skills in the diagnosis, treatment and understanding of fetal CHD. The program is given twice a year and is taught by our fetal cardiology sonographers and physicians from Children’s Colorado and the University of Colorado Hospital. The class is limited to 20 students to encourage group interaction. The overreaching goal of the program is for obstetrical sonographers and physicians to detect more fetal CHD earlier in pregnancy, so affected babies can deliver at a cardiac center of excellence and receive the necessary critical care. We appreciate that learning is a lifelong process! We are happy to give a second opinion or help our students with perplexing cases. For more information about the preceptorship, contact Shari Borcherding at email@example.com or call 720-777-2944.