• Manish Bansal, Shaanemeet Singh, Puneet Maheshwari, David Adams, Marti L McCulloch, Tanuj Dada, Shantanu P Sengupta, Ravi R Kasliwal, Patricia A Pellikka, Partho P Sengupta, and VISION-in-Tele-Echo Study Investigators.
• Medanta - The Medicity, Gurgaon, Haryana, India.
• J Am Soc Echocardiogr. 2015 Jan 1; 28 (1): 75-87.

BackgroundPoint-of-care (POC) echocardiography may be helpful for mass triage, but such a strategy requires adequately trained sonographers at the remote site. The aim of this study was to test the feasibility of using a novel POC echocardiography training program for improving physicians' imaging skills during preanesthetic cardiac evaluations performed in a community camp organized for treating cataract blindness.MethodsSeventeen physicians were provided 6 hours of training in the use of POC echocardiography; nine were taught on site and eight were taught online through a transcontinental tele-echocardiography system. The trained physicians subsequently scanned elderly patients undergoing cataract surgery. The quality of images was graded, and agreement between local physicians' interpretations and Web-based interpretations by worldwide experts was compared.ResultsA total of 968 studies were performed, with 660 used for validating physicians' competence. Major cardiac abnormalities were seen in 136 patients (14.2%), with 32 (3.3%) deemed prohibitive to surgery in unmonitored settings. Although good-quality images were obtained more frequently by physicians trained on site rather than online (P = .03), there were no differences between the two groups in agreement with expert interpretations. The majority of physicians (70.6%) expressed satisfaction with the training (average Likert-type scale score, 4.24 of 5), with no difference seen between the two groups. The training resulted in significant improvements in self-perceived competence in all components of POC echocardiography (P < .001 for all).ConclusionsThis study establishes the feasibility of using short-duration, one-on-one, personalized transcontinental tele-echocardiography education for wider dissemination of echocardiographic skills to local physicians in remote communities, essential for optimizing global cardiovascular health.Copyright © 2015 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

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