Pediatric Informatics: Computer Applications in Child Health (Health ...

20 Telemedicine Applications in Pediatrics 285
Fig. 20.1a Washington, DC Pediatric Telemedicine Community Hospital Network—Map of
Washington, DC metropolitan area showing our tertiary care hospital (Black star) and ten community
hospitals in Maryland where telemedicine (cardiology and/or neurology) is performed. These sites
are Annapolis, Cheverly, Clinton, Frederick, Hagerstown, Leonardtown, Prince Frederick, Rockville
Salisbury, and Silver Spring
ISDN lines (384 Kbps). Over 6,000 studies have been performed from nine
hospitals since our telemedicine program began in 1998 (Fig. 20.1a and b). The
average time from request of a study to having a faxed report at the referring site is
under 30 min. Telemedicine has had a significant benefit to our pediatric cardiology
practice including an average saving of 4.2 person–hours each week from avoidance
of unnecessary consultations. The pediatric cardiologist also records a digitized
version of the study on the telemedicine computer (Fig. 20.2) using MPEG
technology that is of diagnostic quality and allows for “bookmarking” of images
and offline measurements. Reports can be transmitted or faxed immediately to the
referring physician and form a digital medical record and database.
Telemedicine is also used for patient discussions during weekly surgical
case management conference. Multiple forms of digital data (echocardiography,
angiography, x-rays, and MRIs), videotape displays, and audio and video of audience
members can be shared among CNMC, two satellite clinics, the local referral