A pediatric telecardiology system that facilitates integration between hospital-based services and community-based primary care

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

doi:10.1016/j.ijmedinf.2023.105298

A pediatric telecardiology system that facilitates integration between hospital-based services and community-based primary care

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

Authors

Affiliations

¹ Pediatric Cardiology Unit, Buzzi Children's Hospital, 20154 Milan, Italy.
² Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy; Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy. Electronic address: valeria.calcaterra@unipv.it.
³ International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy; IRCCS Auxologico, Clinical Nutrition Unit, Department of Endocrine and Metabolic Diseases, Milan 20145, Italy.
⁴ Arrhythmia and Electrophysiology Unit, Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
⁵ Department of Economics, Management and Quantitative Methods (DEMM), Università degli Studi di Milano, 20122 Milan, Italy.
⁶ Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy; Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy.

PMID: 37972482
DOI: 10.1016/j.ijmedinf.2023.105298

Abstract

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.

Keywords: Children; Community-based primary care; Hospital-based services; Integrated systems; Pediatric telecardiology; Telemedicine.

MeSH terms

Child
Community Health Services*
Hospitals
Humans
Pilot Projects
Primary Health Care
Reproducibility of Results
Telemedicine*