Key result
Telecardiology consultation for 106,942 patients over 9 years resulted in 58% having no heart disease, 26% managed at home with drug adjustments, and 5% requiring urgent hospitalization.
Why the study?
Does telecardiology using transtelephonic electrocardiography improve patient triage and management in primary care?
Observational (n=106,942)
Yes
Does telecardiology using transtelephonic electrocardiography improve patient triage and management in primary care?
Telecardiology in primary care effectively triages patients, avoiding unnecessary hospitalizations for the majority while accurately identifying critical cardiac emergencies.
May aid primary care triage; leaves open confirmation of outcome benefits in randomized trials.
The ITMS telecardiology network started in April 1995. Over nine years, about 7000 peripheral medical users (mainly general practitioners), who were experienced in using transtelephonic electrocardiography and who were spread throughout Italy, conducted teleconsultations with the Telecardiology Centre. A total of 106,942 patients were evaluated. Teleconsultation was carried out for non-cardiac symptoms or routine control for 30,444 patients (28%) and for symptoms suggestive of heart disease for 76,498 (72%). After teleconsultation, 61,908 patients (58%) were reported to have no heart disease, 27,947 patients (26%) had their drug dose adjusted and remained at home, 11,503 patients (11%) were sent to their cardiologist for further investigations and 5584 patients (5%) were urgently hospitalized. Among the hospitalized patients, the echocardiogram demonstrated an ST-elevation coronary syndrome in 1785 patients (32%), a non-ST-elevation coronary syndrome in 2236 (40%) and a life-threatening arrhythmia in 1354 (24%). Telecardiology improves the decision making of general practitioners, avoids unnecessary hospitalizations, reduces the time before treatment in cardiac emergencies, rationalizes health-care costs and promotes home care.
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Molinari et al. (2004) conducted an observational in Symptoms suggestive of heart disease or routine control (n=106,942). Telecardiology (transtelephonic electrocardiography) was evaluated on Clinical management outcomes after teleconsultation. Telecardiology consultation for 106,942 patients over 9 years resulted in 58% having no heart disease, 26% managed at home with drug adjustments, and 5% requiring urgent hospitalization.
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