Telemedicine allows Brisbane cardiologists to offer cardiac tests to people in rural Queensland

Thursday, 27 Aug 2020

A telemedicine program is enabling cardiologists in Queensland to greatly improve access to cardiac testing and monitoring for rural and remote residents.

Cardiologists at the Royal Brisbane and Women’s Hospital have been working with local community healthcare staff in a program to offer exercise stress tests and Holter monitoring remotely at 11 facilities in Queensland in regions around Longreach and Mt Isa.

Reporting their progress in NEJM, they say the Tele-Cardiac Investigations approach has increased testing by 42% with the number of tests performed over a 12 month period rising from 516 before its introduction to 734 afterwards.

And annual testing numbers were doubled for Indigenous Australians, from 63 before implementation to 127.

The program  reduced waiting times to have tests conducted by 45%  (18 fewer days) and reduced time to have results reported by 99% (36 fewer days), resulting in a significant 57 days reduction in the total time from referral to reporting.

Telemedicine allowed 91% of patients to receive testing without having to travel away from their local health facilities, reducing round-trip travel on average by 502 km for patients requiring Holter monitoring.

The clinicians explained that for exercise stress testing, a live video feed of the ECG monitor at the rural facility allowed the telemedicine team to view patient data in real time.

“Local staff performed the exercise stress test with guidance from the telemedicine team, or, alternatively, the exercise stress test system was remotely controlled by the telemedicine team,” they wrote.

“The test results were immediately reported by the telemedicine team with the use of remote access software.

For Holter monitoring, rural staff applied the device with guidance from the telemedicine team. The telemedicine team then remotely accessed the initialisation software to program and start the recording. After the recording was complete, the telemedicine team remotely transferred the data to analysis software at RBWH for reporting.

The team say the results shows that cardiac telemedicine is an ideal program for rural and indigenous populations who are disproportionately affected by cardiovascular disease, and who have reduced access to services, especially in areas that have difficulty in attracting and retaining health professionals.

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