Tele-echocardiography: enhancing quality at the point-of-care

Cardiac point-of-care ultrasound (POCUS) has been rapidly adopted across a variety of practice settings. The popularity stems from the ability to rapidly assimilate findings at the bedside into a diagnosis and treatment plan. The focus has primary been to assess left and right ventricular function, presence of a pericardial effusion, major valvular pathology and inferior vena cava size. Utilisation of POCUS results in fewer missed cardiovascular findings of clinical importance when compared with physical examination alone.1 It also enhances diagnostic accuracy for cardiac conditions including left ventricular systolic dysfunction.2 Medical students and physicians have demonstrated a basic level of competency with as little as two or 3 hours of training.2 3 Many medical schools and post-graduate training programmes have or are in the process of developing curriculums to teach POCUS. Recently, hand-held cardiac ultrasound screening has spread to primary care.4 It can be applied in remote settings without routine access to formal ultrasonography to determine which patients may benefit from a complete echocardiogram.5 6 It is important to note that POCUS cannot supplant echocardiography to thoroughly evaluate significant cardiac pathology due to limited image quality and lack of spectral Doppler. Scan fidelity is also subject to acquisition and interpretation based on the experience of the clinical practitioner. Prior …