Enhancing Prevention Of Coronary Heart Diseases Countrywide Through Telediagnosis Pedro GALVAN ScD. Dipl.-Ing. Biom. ACCE Health Sciences Research Institute (IICS) / Ministry of Public Health (MSPBS) ibiomedica@iics.una.py Asuncion / Paraguay (South America) Fourth WHO Global Forum on Medical Devices

Fourth WHO Global Forum on Medical Devices Clinical background Coronary Heart Diseases (CHD) is the single largest cause of death worldwide, causing 12.7% of total global deaths in 2008. According to the World Health Organization (WHO) CHD is one of the top causes of death in Paraguay, 15.7% of total global mortality in 2017. The global burden of CHD deaths has shifted to low-and-middle income countries as lifestyles approach those of high income countries. Advances in information, communication (ICT) and health technology have enhanced healthcare for many countries around the world. The challenge for low setting countries is to develop a prevention program for CHD using telediagnosis and adopting an appropriate treatment for every individual countrywide. In order to achieve better outcomes and an equal access to healthcare services regardless of social context and physical location for every individual is the ICT to consider as a very promising tool. Fourth WHO Global Forum on Medical Devices

Clinical background (cont.) Populations living in remote areas did not have access to specialist care and quality diagnostic services and thus depended on the low response capacity of their local health system. There were subsequent equity issues between urban and rural populations. In this context the telediagnosis applications should be directed towards developing better equity in the provision of services in remote locations without access to specialists. This study have evaluated the results of a tele-electrocardiography (Tele-EKG) program in remote public hospitals in Paraguay, in order to show how the response capacity of the local integrated health service delivery networks has been improved by providing access to a prevention program for CHD using telediagnosis. Fourth WHO Global Forum on Medical Devices

Fourth WHO Global Forum on Medical Devices Methodology Descriptive study, where the results using telemedicine for diagnosis countrywide in public hospitals were evaluated as tool to improve access to a prevention program for CHD between 2014-18. For these purposes, type of CHD diagnosed and the adherence to evidence-based medications and lifestyle modifications was determined. We analyzed CHD deaths countrywide between 2014 and 2018 and used the telemedicine database to determine patient health center visit frequency, age-specific CHD mortality rates by community and region. Fourth WHO Global Forum on Medical Devices

Fourth WHO Global Forum on Medical Devices Objective This study aims to evaluate the utility of telediagnosis as tool for enhancing prevention of Coronary Heart Diseases countrywide. Fourth WHO Global Forum on Medical Devices

Fourth WHO Global Forum on Medical Devices Results A total of 246,217 remote EKG diagnoses were performed between January 2014 and August 2018. Of the total, 80.6% (198,494) corresponded to adults and 19.4% (47,723) to children. The adult diagnosis were mainly normal (66.3%), sinus bradycardia (11.2%), right bundle branch block (4.8%), left ventricular hypertrophy (4.7%), ventricles repolarization disorder (4.4%), sinus tachycardia (4,4%), ischemia (1.7%), atrial fibrillation (1.1%), left bundle branch block (0.7%), and unspecified arrhythmias (0.6%). The children diagnosis were mainly normal (79.4%), sinus bradycardia (10.6%), sinus tachycardia (3,2%), unspecified arrhythmias (2.8%), right bundle branch block (1.9%), left ventricular hypertrophy (1.0%), left bundle branch block (0.4%), ventricles repolarization disorder (0.3%), and atrial fibrillation (0.2%). The mean adherence rate to the prevention program was 2.3 between 2014 and 2018 for each thousand diagnosis performed. Fourth WHO Global Forum on Medical Devices

Fourth WHO Global Forum on Medical Devices Results Fourth WHO Global Forum on Medical Devices

Fourth WHO Global Forum on Medical Devices Conclusion The results show that the telemedicine can enhance significantly the EKG screening to support a prevention program for cardiovascular diseases and health programs. However, before carrying out its systematic implementation, a contextualization with the regional epidemiological profile must be performed. Fourth WHO Global Forum on Medical Devices

Fourth WHO Global Forum on Medical Devices Thank You!!!! Fourth WHO Global Forum on Medical Devices

Fourth WHO Global Forum on Medical Devices Disclosure The presenter declares no conflict of interest with the materials provided. Fourth WHO Global Forum on Medical Devices