A paediatric cardiology clinic in Belfast has claimed to be the first in the world to pilot ISDN videoconferencing to enable sick children to stay at home under medical supervision.

The trial, which is taking place at the Clark Clinic in the Royal Victoria Hospital, Belfast, allows doctors to check the progress of the patients every week without their parents making a trip to the hospital. If parents have any concerns or problems they can call the clinic, and the doctors on duty can make a diagnosis from the images on their screen.

Gareth Morgan, Clark Clinic

“Through videoconferencing we can ensure that patients continue to receive high levels of care with their parents in a warm and loving home environment,” says Gareth Morgan (above), Specialist Registrar at the Royal Victoria Hospital, who helped to organise the project. “The major benefit has been the reassurance for parents at a very worrying time that expert advice and care is at the end of a telephone line."

The screen resolution is high enough for doctors to see the smallest of tell-tale problem signs, such as any blue colouring of the babies’ lips. The 25fps frame refresh rate is the the same as that on a standard TV; and enables staff to tell whether the patient is having any breathing difficulties or is distressed.

Facilities are available at the clinic to control the focus, position and zoom settings of the camera at the patient’s home.

The experiment is being supported by Questmark, a specialised private videoconferencing company based in Long Eaton, Nottinghamshire. 

Dr Sam McMaster worked closely with the clinic from the start of the project, and initially tried using broadband. “We sat down with the doctors to find out what they wanted to do, and when we showed them what was deliverable they thought it was inferior."

"We spent about over six months looking at all the different options to get the right kind of quality. The broadband doesn’t give the right quality of service; so we chose ISDN, and ISDN is expensive compared to broadband. It was the only transport mechanism that would give reliable and consistent quality.

“We have put the equipment into 18 kids’ homes and the results have been phenomenally successful. Just to be involved with the project is amazing."

The project also promises to help the Royal Victoria Hospital conserve resources and also save parents time, as many parents in rural areas have to visit the cardiology department in the city. “To avoid stretching our facilities we prefer patients to return home as soon as it is safe to do so,” says Morgan. “We expect the trial will show tangible economic benefits for the hospital."

If the pilot proves successful, the service may be extended to other clinics. Questmark aims to reduce cost for the service to £100 per patient, per month, and be able to supply a pool of equipment that can be installed in the homes of every patient. This would be paid for through normal NHS funding procedures.

The current trial needs £15,000 to continue until the end of the year. Donations can be made to Gareth Morgan at The Clark Clinic, The Royal Belfast Hospital For Sick Children, Grosvenor Road, Belfast, BT12 6BA.