{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T03:33:56Z","timestamp":1778038436309,"version":"3.51.4"},"reference-count":49,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2016,11,4]],"date-time":"2016-11-04T00:00:00Z","timestamp":1478217600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Telemed Telecare"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The global burden of rheumatic heart disease is nearly 33 million people. Telemedicine, using cloud-server technology, provides an ideal solution for sharing images performed by non-physicians with cardiologists who are experts in rheumatic heart disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We describe our experience in using telemedicine to support a large rheumatic heart disease outreach screening programme in the Brazilian state of Minas Gerais.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Programa de Rastreamento da Valvopatia Reum\u00e1tica (PROVAR) is a prospective cross-sectional study aimed at gathering epidemiological data on the burden of rheumatic heart disease in Minas Gerais and testing of a non-expert, telemedicine-supported model of outreach rheumatic heart disease screening. The primary goal is to enable expert support of remote rheumatic heart disease outreach through cloud-based sharing of echocardiographic images between Minas Gerais and Washington. Secondary goals include (a) developing and sharing online training modules for non-physicians in echocardiography performance and interpretation and (b) utilising a secure web-based system to share clinical and research data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PROVAR included 4615 studies that were performed by non-experts at 21 schools and shared via cloud-telemedicine technology. Latent rheumatic heart disease was found in 251 subjects (4.2% of subjects: 3.7% borderline and 0.5% definite disease). Of the studies, 50% were preformed on full functional echocardiography machines and transmitted via Digital Imaging and Communications in Medicine (DICOM) and 50% were performed on handheld echocardiography machines and transferred via a secure Dropbox connection. The average time between study performance date and interpretation was 10 days. There was 100% success in initial image transfer. Less than 1% of studies performed by non-experts could not be interpreted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>A sustainable, low-cost telehealth model, using task-shifting with non-medical personal in low and middle income countries can improve access to echocardiography for rheumatic heart disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1357633x16677902","type":"journal-article","created":{"date-parts":[[2016,11,4]],"date-time":"2016-11-04T22:18:29Z","timestamp":1478297909000},"page":"101-109","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Telehealth solutions to enable global collaboration in rheumatic heart disease screening"],"prefix":"10.1177","volume":"24","author":[{"given":"Eduardo LV","family":"Lopes","sequence":"first","affiliation":[{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea Z","family":"Beaton","sequence":"additional","affiliation":[{"name":"Children\u2019s National Health System, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno R","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Tompsett","sequence":"additional","affiliation":[{"name":"Children\u2019s National Health System, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia PA","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay","family":"Perlman","sequence":"additional","affiliation":[{"name":"Children\u2019s National Health System, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana C","family":"Diamantino","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaciane KB","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassio M","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria do Carmo P","family":"Nunes","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo","family":"Bonisson","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ant\u00f4nio LP","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina da Universidade Federal de Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig","family":"Sable","sequence":"additional","affiliation":[{"name":"Children\u2019s National Health System, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Programa de RastreamentO da Valvopatia Reum\u00e1tica (PROVAR) investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,11,4]]},"reference":[{"key":"bibr1-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.01.364"},{"key":"bibr2-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(05)70267-X"},{"key":"bibr3-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.45.3.543"},{"key":"bibr4-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2012.7"},{"key":"bibr5-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.06.088"},{"key":"bibr6-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-012-0343-1"},{"key":"bibr7-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2013.08.004"},{"key":"bibr8-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308236"},{"key":"bibr9-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.114.002324"},{"key":"bibr10-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-016-0205-7"},{"key":"bibr11-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.03.006"},{"key":"bibr12-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2012.12.012"},{"key":"bibr13-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph10116131"},{"key":"bibr14-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1258\/1357633971931165"},{"key":"bibr15-1357633X16677902","first-page":"111","author":"Rendina MC","year":"1998","journal-title":"Proc AMIA Symp"},{"key":"bibr16-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1258\/1357633981931416"},{"key":"bibr17-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1089\/107830299311907"},{"key":"bibr18-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1542\/peds.109.1.e3"},{"key":"bibr19-1357633X16677902","first-page":"97","volume":"59","author":"Awadallah S","year":"2006","journal-title":"S D Med"},{"key":"bibr20-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1258\/135763306779378636"},{"key":"bibr21-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1258\/jtt.2008.003011"},{"key":"bibr22-1357633X16677902","first-page":"181","volume":"29","author":"Gomes R","year":"2010","journal-title":"Rev Port Cardiol"},{"key":"bibr23-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.11.099408"},{"key":"bibr24-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2013.0279"},{"key":"bibr25-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"bibr26-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.008727"},{"key":"bibr27-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)61340-X"},{"key":"bibr28-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60054-8"},{"key":"bibr29-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1590\/S0066-782X2009000800003"},{"key":"bibr30-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.11.099408"},{"key":"bibr31-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1590\/S0066-782X2011005000080"},{"key":"bibr32-1357633X16677902","first-page":"345","volume":"35","author":"Marcolino MS","year":"2014","journal-title":"Rev Panam Salud Publica"},{"key":"bibr33-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118357"},{"key":"bibr34-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.03.006"},{"key":"bibr35-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.046"},{"key":"bibr36-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0078450"},{"key":"bibr37-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-014-0424-9"},{"key":"bibr38-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2013.05.018"},{"key":"bibr39-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(96)90103-9"},{"key":"bibr40-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(09)90049-X"},{"key":"bibr41-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.82.2.222"},{"key":"bibr42-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)00171-X"},{"key":"bibr43-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2014.0188"},{"key":"bibr44-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2013.0307"},{"key":"bibr45-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-0356"},{"key":"bibr46-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1109\/TITB.2012.2227336"},{"key":"bibr47-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2012.03014.x"},{"key":"bibr48-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2011.08.007"},{"key":"bibr49-1357633X16677902","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2012.157"}],"container-title":["Journal of Telemedicine and Telecare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1357633X16677902","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1357633X16677902","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1357633X16677902","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:11:22Z","timestamp":1777691482000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1357633X16677902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,4]]},"references-count":49,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1177\/1357633X16677902"],"URL":"https:\/\/doi.org\/10.1177\/1357633x16677902","relation":{},"ISSN":["1357-633X","1758-1109"],"issn-type":[{"value":"1357-633X","type":"print"},{"value":"1758-1109","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,4]]}}}