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DIVO is a Life Saver Say Pediatric Cardiologists

August 08, 2006
by Barbara Kram, Assistant Editor at www.DOTmed.com

On her way to Children’s Hospital Los Angeles one Saturday in June, pediatric cardiologist Elizabeth R. De Oliveira, MD was paged by the neonatologist at the emergency room of Queen of the Valley Hospital more than 20 miles away. A week-old baby presented with difficulty breathing and a weak pulse. “I couldn’t drive from Hollywood all the way to West Covina in time,” Dr. De Oliveira said. “I told the neonatologist I am going to make arrangements to get a bed and an ambulance to pick up the baby for transport to a surgical center, and in the meantime get a STAT echo and you can transmit via DIVO.”

DIVO (digital images from video output) is a simple medical device that connects to an ultrasound machine and digitizes the echocardiogram so it can be sent over a local area network or the Internet. “It just plugs into the video and audio outputs of the ultrasound machine. The images can be viewed on any Windows computer,” said Don Wauchope, creator of the device.

DIVO speeds transmission of critical medical images and sound where needed so specialists can be consulted to initiate intervention right away. (The alternative is that hospitals send videotapes to physicians via messenger.)

While in the parking lot at Children’s Hospital Dr. De Oliveira grabbed her laptop computer with mobile broadband card from the trunk of the car. “By the time I went upstairs and was inside the unit…I already knew enough about the baby to start treatment and I alerted the unit to the kind of treatment the baby needed,” she said.

Her colleague at Pacific Pediatric Cardiology Medical Group, Robert D. Loitz, MD added, “It eliminates the delay that we would invariably have covering acute care nurseries throughout LA County in being able to immediately diagnose babies with often life-threatening heart disease. Instead of being bumper to bumper on the 10 Freeway, the echo is coming to us at the speed of light ….That can be the difference between living and dying.”

Why didn’t somebody think of DIVO before? Imaging equipment can certainly provide digital output but it often requires proprietary viewing software from the OEM to interface. The beauty of DIVO is its universal application. “The strength of the system is in its accuracy but really simplicity,” Dr. Loitz noted.

About 40 DIVO units are in use to date, many in pediatric echocardiography. While DIVO could be used for any specialty, it’s particularly helpful in this field. “The incidence of severe heart disease isn’t so extreme or common that there are practitioners in every community. We have to provide care for an entire region,” Dr. Loitz explained. He and his colleagues cover more than 20 community hospitals in Southern California.

Clinical issues in pediatrics also make DIVO advantageous. “In pediatric cardiology we are dealing with very complex abnormalities of the structure of the heart,” Dr. Loitz said. “That requires extended imaging as you’re slowly sweeping from one [visual] plane to another. You’re not capable of doing that if you’re constrained to five-second loops, as some other systems that do digital recordings of ultrasound.”

DIVO can record extended studies including Doppler audio to give physicians the whole picture. It does not require any additional work on the part of technologist conducting the exam; in fact, the results are sent so quickly that the doctor on the receiving end can immediately direct the technologist if another image angle is needed.

There’s no doubt that DIVO saves lives. “I saw the baby twice already in the office; the baby is now about two months old and wonderful…and her mom is so happy. She literally brought in a baby that was dying and now the baby is thriving. It’s amazing,” Dr. De Oliveira said. “If I had to drive 20 miles in traffic on a Saturday to read the study and then decide the baby needed [transportation] it would be a delay, and delaying on this very critically ill baby would not have had the same outcome. I am totally sure of that.”


[Note: Case example details and identifying information have been withheld or changed to protect patient confidentiality]


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