[Is transmission of heart murmurs via e-mail cost saving?].

Background: The use of pre-recorded heart murmur in an electronic referral for a remote consultation can save children and their parents from having to travel to the nearest out-patient clinic. The heart sound can be recorded by the GP at the local health clinic and sent by e-mail to the specialist. 41 clinics in the North Norway healt region have invested in equipment that makes pre-recorded sound referrals possible. This study analyses whether this investment is a cost-saving technology or not.

Methods: A yearly average of 50 children with a heart murmur are referred to a specialist in Troms. The costs of using pre-recorded telemedicine were compared to the costs of patient travelling to the nearest secondary care centre.

Results: Pre-recorded heart sound referrals cost from 216 000 NOK more per year than the alternative of bringing patients to the out-patient clinic. The number of children with a heart murmur needed in order to break even must exceed 195 per year, i.e. 1.7 children per GP per year.

Interpretation: The number of children with a heart murmur in Troms is too low for this method to be a cost-saving approach.