Abstract 16748: Application and Utility of iPads in Pediatric Tele-Echocardiography

Abstract

The remote acquisition and interpretation of medical information (telemedicine) is an integral part of health care. Radiologic images (eg CT scans) can be accurately interpreted on tablet devices with high display resolution. To date, there have been no published studies on the use of iPads for interpretation of pediatric echocardiograms (echo). OBJECTIVES: We evaluated and compared the quality of echo images, diagnostic accuracy, and review time for pediatric echos using 3 different modalities: remote access on an iPad Air (iPad), remote access via computer (Remote), and direct access on computer Ethernet linked to the server (Direct). METHODS: Fifty archived pediatric echos were re-interpreted using the 3 modalities. Studies were analyzed blindly and independently by two pediatric cardiologists. Outcome measures included: time to review, diagnoses and discrepancies, image quality, sharpness, and jitter. Diagnostic accuracy was assessed by comparing the study diagnoses with the original interpretation in patient’s chart. Discrepancies were rated as none, minor (one grade difference in severity of lesion, patient management not affected), or major (> one grade difference in severity of lesion, management affected). Remote desktop, Wi-Fi, Verizon, and Ethernet were used. RESULTS: Combining data from both reviewers, there were no major discrepancies, and 9.77% minor discrepancies. There were no significant differences in discrepancies as a function of device (iPad, Remote, Direct). Remote yielded significantly (p < 0.001) worse ratings for image quality, sharpness and jitter with iPad next and Direct yielding the best ratings (Table). Overall interpretation times were different (p < 0.0001) between viewing modes, (iPad longer vs remote vs direct). CONCLUSIONS: Remote echo review on iPads is possible, yields very good-to-excellent image quality, and allows for convenient, and reliable interpretation of pediatric echos.