Telecardiology: Supporting The Decision-Making Process In General Practice. Journal Of Telemedicine - Methods

Methods
Ninety-three GPs, working in 26 health centres serving a population of about 200,000 in north London, participated in this trial. GPs were offered telecardiac consultation from their practices or from patients' homes. Using any terrestrial or cellular telephone lines, they could obtain direct accessto a cardiac monitoring centre (CMC) staffed by cardiology registrars and
cardiac technicians. The registrars had easy access to a consultant cardiologist for discussion of any difficult or doubtful cases. GPs were supplied with an automatic standard lZ-lead electrocardiogram (ECG) transmitter with direct voice access to the CMC for cardiac consultation and ECG interpretation. The CMC, based at the Cardiology Department in Edgware General
Hospital, operated a 24-hour service, providing continuous coverage, which included collecting and analysing data, consulting and reporting. When required, the GP or nurse could telephone, identify the patient by name and date of birth, and provide clinical details, the patient's history and the reason for consultation. The caller could then transmit a standard 12-lead ECG signal. A brief consultation, discussing diagnosis and patient management, followed and a full report, including ECG print-out, was mailed or faxed to the GP. Timely appointments were made on-line for further outpatient assessmentsif, required. Instant admission for patients with acute myocardial infarction was arranged when indicated, which involved prewarning
the hospital's medical teams.