Asynchronous tele-expertise (ASTE) for prenatal diagnosis is feasible
and cost saving: results of a French case study
Roch GIORGI
Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, ISSPAM, Hop Timone, BioSTIC, Biostatistique et Technologies de l’Information et de la Communication, 13005 Marseille, France;
Author ProfileAbstract
Objective: The objective of this study was to assess the potential of
the use of asynchronous tele-expertise (ASTE) to provide prenatal
diagnosis from a medical and economic point of view. Population:
Patients screened by a midwife at a primary center. Methods: A technical
and clinical evaluation was conducted retrospectively, and a cost
minimization study compared asynchronous tele-expertise to face-to-face
consultations that would have been performed without ASTE. Main outcome
measures: In our study we assessed the feasibility of TEAS, what were
the origins of the requests for expertise, whether patients need to be
moved and the reasons for doing so, and the costs of tele-expertise and
conventional consultation. Results: In this retrospective analysis 322
advices from 260 patients were interpreted remotely via a platform. The
results revealed a 90.68% feasibility of transmitting in a satisfactory
and interpretable way ultrasound images and videos via the
tele-expertise platform (292/322 files). In our series, asynchronous
analysis allowed the required physician to make an accurate diagnosis
and identify 74 (28.5%, 95% CI [23% –33.9%]) pregnancies
associated with malformations and rule out abnormalities in 186 (71.5%,
95% CI [66.1% –77%]) of the cases. Asynchronous analysis
prevented the displacement of 72.7% (189/260) patients. The practice of
ASTE would result from a societal point of view, an average saving of
\euro 123.40 per patient. Conclusion: The use of asynchronous
tele-expertise (ASTE) using fetal ultrasound, is feasible and may
contribute to increased diagnostic accuracy while generating a
significant reduction in costs for society. Funding: None