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Echocardiography has been around for more than two decades, but recent technological advances—especially in the quality of image resolution—have increased its precision in evaluating the structure and function of the heart. So accurate are the state-of-the-art, $250,000 machines now in use at Hopkins, it’s possible to diagnose heart defects as early as 16 to 20 weeks after conception, providing a prenatal diagnosis that gives advance warning of many cardiac problems to parents and physicians.

“We can be very accurate in diagnosing congenital heart diseases,” says Philip J. Spevak, M.D., director of pediatric echocardiography, a service that acts as an important resource for other hospitals and is now exploring the viability of telemedicine to make access to its technology and expertise even easier.

The labs currently receive videotapes via courier from many regional hospitals and even some from around the world. While these facilities can conduct their own echocardiograms, they rely on Spevak’s expertise and on Hopkins’ echo-reading equipment for precise interpretations of the results. With the telemedicine project, the transmission of digitized echocardiographic data would take place over high-speed lines. “The image quality is great,” Spevak says. “We’ve tested the technology, so we know that it works.” Such a system also might simplify the logistics of cardiac surgery and reduce the cost. Currently, a cardiac echo expert must visit the operating room twice—once at the beginning and again when the operation is finished in almost any pediatric cardiac surgery. With a digital system, the echo could be viewed in real time from a distant location.

Hopkins is still in the early stages of implementing digital video transmission, but Spevak is enthusiastic about its potential. “This is going to be a big help,” he says, “because we’ll be able to see the data at the same time” as will doctors in their own offices, allowing for discussions of results that may help the outside doctors learn more about the imaging of congenital heart disease. It may also eliminate the need to transfer some patients, by helping doctors decide more quickly which patients can be treated at community hospitals and which require more specialized care here.

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