Original article
The Architecture of a Mobile Outreach Echocardiography Service

https://doi.org/10.1016/j.echo.2006.06.007Get rights and content

We describe the outreach echocardiography program at our tertiary care referral center in southeast Minnesota. Cardiac sonographers from our institution transport ultrasonographic imaging equipment to regional hospitals and clinics where they perform complete transthoracic echocardiographic examinations. Digital images from standard 2-dimensional, color flow, and Doppler echocardiography are transferred to our clinic for interpretation by a cardiologist. The outreach program enables physicians without access to echocardiography to use this powerful diagnostic tool in the local evaluation of patients with suggested or known heart disease. We detail the organization of our outreach echocardiography program and emphasize the team approach that facilitates optimal image acquisition, prompt interpretation, and timely reporting of results.

Section snippets

Our outreach echocardiography practice

Drs Bijoy Khandheria, Jamil Tajik, and James Seward established our outreach echocardiography program in 1989 in collaboration with several sonographers and one secretary. Since then, our outreach echocardiography program has grown steadily and currently treats a high volume of patients (Figure 1, Figure 2). Today, the outreach echocardiography team includes 12 full-time cardiac sonographers, 24 cardiologists trained to interpret echocardiographic studies, 3 secretaries, and 1 full-time

Image and data management

The standard of practice at our echocardiography laboratory is a comprehensive examination that includes extensive and methodic image acquisition and Doppler-based hemodynamic quantification. The goal is to obtain a systematic assessment of the structure and function of the heart and great vessels to provide information that will aid patient treatment. We apply the same standard of practice to our outreach echocardiography program.

Our outreach practice benefits from a robust technologic base.

Outreach practice personnel

The success of our outreach echocardiography program depends on a highly trained and dedicated team of outreach sonographers. The real-time collaboration that occurs routinely among cardiologists and sonographers at our institution’s main echocardiography laboratories cannot be duplicated within the outreach program. Therefore, our outreach sonographers are required to make independent decisions about acquiring relevant supplemental clinical information, optimal images, and important data.

Conclusion

We have described the history, philosophy, and organization of our outreach echocardiography program. Its success may be attributed to the highly trained and dedicated cardiac sonographers and secretarial support staff, state-of-the-art ultrasonography equipment, and prompt interpretation by cardiologists. We have described our program to encourage other cardiology groups that are considering establishing an outreach practice or seeking to improve the proficiency of an existing program. We hope

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