Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Apr 3, 2019
Open Peer Review Period: Apr 8, 2019 - Apr 15, 2019
Date Accepted: Jun 11, 2019
(closed for review but you can still tweet)
Construction of a three-synchronization double-real-time interactive remote echocardiography consultation system and its initial effect
ABSTRACT
Background:
China has a vast territory, and the healthcare service level, especially UCG diagnosis skills, in remote regions is still low. The patients usually need to travel long distance to go to superior hospitals for confirmed diagnosis, which is labor- and money-consuming. Under the general context of fast development of high-speed communication technology, telemedicine will be of great help for improving the diagnosis and treatment at grassroots hospitals.
Objective:
This study aimed to discuss the feasibility, clinical value and popularization value of a three-synchronization double-real-time interactive remote ultrasound echocardiography (UCG) consultation system that is built based on cloud computing technology.
Methods:
By using the 4G cloud computing platform coupled to unique dynamic image coding and decoding and synchronization technology, multi-dimensional communication information in the form of voice, texts, and pictures was integrated. A remote UCG consultation system connecting Henan Provincial People’s Hospital and two county-level grassroots hospitals 300 km away was built. This system was applied in consultation for 45 patients.
Results:
This remote UCG consultation system achieved remote consultation for 45 patients. The total time consumed was 341.31 min, and the average consultation time for each patient was 7.58±6.17 min. Among the 45 patients, there were 3 patients diagnosed as congenital heart diseases at the grassroots hospitals (7%), and 42 patients acquired heart diseases (93%). After expert consultation, there were 5 patients (11%) finally diagnosed as congenital heart diseases, 34 patients (76%) acquired heart diseases, and 6 patients (13%) no heart abnormalities. Compared with the initial diagnosis at the grassroots hospitals, remote consultation using this system found new abnormalities in 7 patients, accounting for 16% of the total; confirmation was made in 6 patients, accounting for 13%; abnormalities were excluded in 6 patients, accounting for 13%. The expert opinions agreed with the initial diagnosis at the grassroots hospitals in the remaining 26 patients, accounting for 58%. Besides, several questions concerning rare illnesses raised by the doctors at the grassroots hospitals were answered. The satisfactory rate was both 100% for patients and doctors.
Conclusions:
The three-synchronization double-real-time interactive remote UCG consultation system that was built based on cloud computing service and unique dynamic image coding and decoding and synchronization technology had high feasibility and applicability, and was worthy of popularization.
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