Tele-stress testing to help our rural colleagues

Dr Adam Scott 1

1 Director of Cardiac Sciences, Cardiac Investigations Unit, Royal Brisbane and Women’s Hospital

 

In rural hospitals there exists a significant time and cost constraint on the physicians ability to directly supervise Exercise Stress Tests (ESTs). This has resulted in significant delays in access. Low volumes of tests performed has resulted in de-skilling of staff which has caused premature cessation of the EST.

Supervision and education for these staff can be provided via telehealth during ‘live’ ESTs at the rural hospital.

The RBWH and Longreach Hospital utilised trolley-based videoconference units that can pan, tilt and 12x zoom a camera, which is remotely controlled by the RBWH clinicians to get the best angle of the patient on the treadmill or bed; it can also be used to zoom in on the operator console to provide remote assistance in the operation of the stress test. Another important feature is the ability to directly connect into the stress test unit to send a direct live image of the ECG, allowing the clinicians at the RBWH to have two screens setup; one with a live image of the patient and the other with a live image of the ECG. 2-way audio is provided via high quality microphones at both ends and allows the clinicians to provide instructions in real-time.

Tele-stress testing is an effective method of supporting rural staff to ensure patients receive a diagnostic test result, thereby avoiding patient travel to a metropolitan hospital to have the same procedure performed thus reducing travel costs, reducing waiting times and days delayed for further treatment for positive test results