Previously, cardiac patients having simple procedures, for angioplastys or angiograms, were treated in the mobile unit at Sligo and their details were put on a disk and sent by post to cardiologists in St James's.

Doctors there would then look at the pictures and try and determine whether or not the patient in question would need to be referred to Dublin for further treatment.

If they did need surgery, they would travel up to Dublin a few days later in an ambulance (when one was available) and arrive as an in-patient.

"This process took a long time, and was difficult because there were a lot of images on one disk, and we had to constantly call Sligo to get more background information. The doctor there would not necessarily have the images in front of him, so it was a time-consuming and stressful procedure," said Dr Crean.

He said that building the necessary cardiology unit in the hospital, or any hospital around the country, was not viable because it could cost up to 2 million to build, equip and staff it, and he doubted funds would be made available for this.

"This is why many regional hospitals do not have the facilities for cardiovascular surgery, and why the teleconferencing facility here is so necessary," he said.

"To do an angiogram, and find out if somebody has blocked arteries, means coming in and having a procedure done in a special room, which needs to be staffed with highly trained personnel and equipment.

"These types of facilities are not available all over the country, which is why Sligo began the process of getting the catheter lab to serve patients from Sligo, Letterkenny and Leitrim," he said.

"It can actually free up beds here because cardiac patients being referred from Sligo have already been diagnosed at the teleconference, so they do not need to be admitted as in-patients for assesment," said Dr Crean.

The system also allows doctors the freedom to confer with each other without having to endure lengthy delays and complications.

It also provides excellent educational benefits, said Dr Crean, because one hospital usually has something new to learn from the other - it allows doctors to broaden their perspectives.

Every Wednesday, doctors at both hospitals hold a conference where they view certain patient's x-rays and procedures - available on the computer dadabase between both hospitals - and discuss possible treatment and results.

The system, when logged on to from both locations, calls up each patient's statistics, procedure photographs and backgrounds, along with x-rays and any other diagnostic information.

Consultants at Sligo are extremely happy with the service, and told Dr Crean that it is almost as if their hospital has become another department in St James's as they have become so close and connected.

Dr Donal Murray, consultant physician at Sligo General Hospital, spoke to IMT at about the advantages to both doctors and patients from his side, and said that the number of cardiac patients who had recieved treatment from a consultant in Dublin had doubled since the system began early this year.

Previously, Dr Murray had to travel up to Dublin at least once a fortnight to confer with consultants in St James's, and to decide whter or not particular patients needed to be referred fr further treatment.

"This was a slow, arduous process that was also extremely inefficient," he said. "Sending the patient's details by post only improved on this slightly but now we can transmit them overnight and simultaneously dicuss them the next day.

"There are also, of course, enormous advantages for the patients who get very quick access to the opinion of an interventional cardiologist, and to a cardiac surgeon, and who can immediately find out if they need to be further operated on," said Dr Murray.

He said that previously, very sick and unstable patients had to travel for up to five hours to get Dublin just to be diagnosed. they then had to endure the same process again if they needed further treatment.

He agreed that the biggest advantage was from the patients point of view, as they no longer had to wait and wonder interminably when an if they would be treated.

"Clearly, in this day and age, there are issues of quality control and competence assurance, but another huge advantage is that the teleradiology system assures that my patients' details are being reviewed by my colleagues; literally the quality of the films are being further assessed. If they, or if the decision-making on the data, were unsatisfactory, it would be highlighted and that is very important because when there are difficulties with a patient it is better to have a number of opinions," said Dr Murray.

He no longer feels like one consultant in isolation, and added that his patients were being treated as if they were already patients in St James's.

Dr Murray also said that it was a pit more hospitals in Ireland did not have access to a catheter lab so they, too, could benefit from the service.

The innovative system was designed by CAPTEC, and Irish company that develops technology for hospital systems, among other industries.

Mr. Jon Kennedy, technical director of the company, told IMT that they are delighted their system has benefited so many cardiac patients, and that they are continuing to help improve cardiac health care in Ireland.

An open day was held in St James's hospital earlier this month to show and explain the teleconferenceing system and it's results.

Mr. Fred Kennedy, the managing director of CAPTEC, said that they were currently developing similar systems systems for other hospitals both in Ireland and abroad.

Sandra Ryan - Irish Medical Times, 29th November 2003.