South African children’s hospital uses video to train cardiologists

Cape Town’s Red Cross Children’s Hospital has equipped its cardiology department with a Polycom video-conferencing solution to help teach life-saving surgery techniques to medical students and bring world-class expertise into to its operating theatres.

Although South Africa is one of the most developed countries in Africa, it still suffers from deep-rooted structural inequality which, in turn, has major repercussions for paediatric care.

As a result, the hospital receives the majority of its patients from exceptionally poor and marginalised communities, with a third younger than a year old.

South Africa also suffers from a massive shortage of trained doctors and surgeons – nationally it produces barely 1,200 per annum and many of those leave the country after qualifying.

As such, said hospital ICT manager Jerome Corns, the hospital was receiving a large and growing number of critically ill children, but had limited resources and little access to trained paediatric cardiologists able to perform cardiac catheterisation procedures – an umbrella term for a number of heart operations that can be either diagnostic or therapeutic.

To remedy this, the hospital’s IT department hit on the idea of using a single teleconferencing system to kill two birds with one stone – offering live surgery broadcasts to help train new doctors, and to help its surgeons benefit from the expertise of the world’s top cardiologists.

Corns built on an existing telemedicine system deployed by the hospital in other departments, and chose Polycom’s RealPresence web and media suite products, backed up by its RealPresence 500 utility card, to move it around.

“We did look at other options, such as Cisco, but we found Polycom gave us the higher resolution with lower bandwidth requirements that we needed,” said Corns. “Bandwidth is a huge problem in South Africa.”

Although the hospital is able to use South Africa’s National Research Network (Sanren), which provides it with gigabit links, it could not rely on the network to handle their bandwidth requirements.

This is because once traffic starts moving outside the world of academia it becomes more challenging for people at smaller, rural hospitals that may not have such fast connections to access the teaching demonstrations.

“We obviously have to work with whatever is available,” said Corns, “and it is getting better all the time – there is more and more fibre, 4G is improving – but the key thing is that the viewer’s endpoint is able to adapt to whatever technology you are using.”

With outside help, the hospital designed a bespoke middleware product to link the Polycom system to its surgical equipment, such as x-rays and heart monitors, to further enhance the system’s utility to remote viewers.

It has now run a number of live surgery broadcasts in which its cardiologists perform catheterisation procedures in real-time, explain at each turn exactly what they are doing, and take questions over the secure HD video stream. Viewers only need a standard web browser on a laptop or mobile device to join in.

So far, said Corns, it has realised a number of benefits from the new system, allowing it to reduce the travel costs for physicians. On the clinical side, more patients are now able to receive potentially life-saving procedures without resorting to risky open heart surgery.

Additionally, senior cardiologists from as far afield as Australia, the Netherlands, New Zealand and the US have been able to share their knowledge and expertise with the students through sessions run through a network called Cathchat, supported by Polycom channel partner Kathea, an established local visual collaboration specialist.

Corns said the Polycom system had created an “open channel of learning”, and he expects to continue to use the technology on a permanent basis. ... ... ... ... ...