Utilisation of telemedicine in paediatric cardiac emergencies during the COVID-19 pandemic: How to set it up, develop and sustain inCollaboration with citizens as stakeholders

Abstract Introduction The Welsh Paediatric Cardiac Telemedicine Service has been delivering teaching, training, and education for healthcare providers for the past 15 years. In addition, telemedicine has been a fundamental tool for providing emergency diagnostic and therapeutic services to children presenting with suspected cardiac diseases to district general hospitals in South Wales. In this paper, we share our unique experience in emergency telemedicine consultations during the COVID-19 pandemic in fetuses, neonates and children who presented with severe cyanosis, respiratory distress, arrhythmias, or cardiovascular compromise. Methods Specialists across Wales worked in partnership with national informatics services, transport services, industry, patients and the third sector to deliver a two-phase project utilising “plan, do, study, act” methodology. Results Building on previous success, the second phase delivered 32 successful telemedicine consultations over seven months utilising the new technology and process. A number of other secondary benefits were also realised including educational, recruitment and multidisciplinary meetings. Conclusion The Welsh Paediatric Cardiology Telemedicine Service has demonstrated its true utility, such that acute cardiac emergencies relating to even ductus-dependent major congenital heart anomalies can be attended and managed in the most effective way by online interactions between a paediatric cardiologist and local paediatricians. This study paves the way for the use of live tele-echocardiography in the diagnosis of major cardiac anomalies without the need for the specialist being physically present. Therefore, this novel modality of telemedicine use can be adopted to help remove health inequalities in communities which are distant from tertiary specialist centres.