When I started working at the University of Pretoria in 2011, I introduced a system to assist our referral hospitals and patients within the northern part of Gauteng and in Mpumalanga, where no cardiologists are working within the state system. 

Many referral hospitals do not have expensive equipment or technology, which is often associated with cardiovascular care (like echocardiograms or even ECG machines). However, it has still been possible for us to introduce a digital system to use our specialist expertise to assist these referral hospitals on a case-by-case basis.  

This system is such that when a doctor at a referral hospital attends to a patient, they can approach us digitally for assistance.  
This involves them sending available information regarding the patient (blood test results, ECGs etc.) through whatever platform they can access.  There are three options commonly used: SMS, Whatsapp, or posting the information on our digital system for an opinion.  Once the Department of Cardiology receives this information, one of our consultants or trainee cardiologists can contact the doctor directly and advise how the patient can be assisted.  We are all cautious about confidentiality in this whole process to ensure that the records are only accessed by the medical personnel who need to see the information.

The system is beneficial for patients with severe heart failure or heart attacks, as life-saving emergency treatment can be immediately commenced. Often, the referral doctors do not have the expertise to initiate this treatment comfortably. An excellent example of this is lytic, which we use to melt the clot in a patient’s heart when they have a heart attack.  Delaying the commencement of such treatment makes all the difference in their outcomes, so it is helpful to start them immediately.  

Often these ill patients are transferred to Pretoria for the rest of their care, but the transfer via ambulance can easily take 6 hours, so this digital system often saves their lives.