Association Journal, Khan and colleagues recommend that physicians should still confirm resting heart rates with medical-grade equipment But they do appear to be supportive of the notion of wearable technology by saying that by use of wearable device–based telemedicine, the wearer takes a voluntary step toward improving his or her health.106 Patient Care Conferences/Second Opinions While most of the published telemedicine data is on clinical applications, the most prevalent use case may be multimodality videoconferencing and sharing of images via cloud technology Many programs conduct multiple patient care and educational conferences each week that include physicians within the practice, referring physicians, and trainees who connect via telemedicine Echocardiograms, angiograms, MRIs, and CTs are shared along with relevant patient data for clinical decision making with input from a multidisciplinary team, many of whom are not available to attend these meetings in person Many of these images are shared in advance via cloud server for systematic review Secure login and encryption is utilized to protect patient confidentiality Participants who connect remotely can do so from telemedicine rooms that have been set up at remote sites as well as personal computers, tablets, and smart phones with installed videoconferencing programs and applications Additional technology enables a connection between the videoconference and collaboration tools so that those without direct access to the videoconferencing program can connect via a secure website Teleconsultation between cardiologists for complex cases can thus extend the concentrated expertise of large tertiary facilities.63,107 Remote Monitoring Home monitoring incorporates automated telemedicine technology108 for a wide variety of diseases in adults including diabetes,109 chronic respiratory disease,110 congestive heart failure,111 and hypertension,108 as well as children with asthma.112 These devices are usually tablet sized and connect to a variety of peripheral devices (hard-wired or wireless, usually Bluetooth) including scales, heart rate and pulse oximeter monitors, blood pressure devices, glucometers, and peak flow meters Many vendors are now integrating directly with commercially available tablets and smartphones These devices can combine standardized management with patient and parent education modules These devices then transmit data (cellular network or wired or wireless Internet connection) and can be reviewed with software that allows for serial comparisons and red flags for outlying or missing data Home telemonitoring programs for adults with congestive heart failure using automated daily capture of weight, blood pressure, heart rate, and oxygen saturation and transmission to a nurse practitioner resulted in fewer admissions, shorter lengths of stay during admissions, lower health care costs, and improved quality of life.113 A meta-analysis of home telemedicine monitoring of patients with congestive heart failure showed reduced mortality, decreased number of hospitalizations and the use of other health services, and improved quality of life.111 Infants with single ventricle physiology are at a high risk of mortality and morbidity between stages I and II of palliation after they are discharged from the hospital.114 Interstage mortality has been shown to be reduced by homemonitoring.115 The Boston group presented their data at the American College of Cardiology meeting in 2013 showing improved somatic growth with no increase in inpatient resource utilization, and a reduction in reoperation using homemonitoring for interstage children Telemedicine-based home surveillance devices, like a tablet PC, are now routinely used Telemedicine with the power of cloud servers and data warehouses provide secure and nearly instantaneous transfer of patient information Heart centers have trained interstage monitoring teams with the experience and resources to triage and address multiple patient alerts that come to them daily Patients have expressed a preference for this kind of tablet PC monitoring over the notebook-based log for monitoring overwhelmingly.116 Prominent leaders in our field are calling for consolidation ... hospital.114 Interstage mortality has been shown to be reduced by homemonitoring.115 The Boston group presented their data at the American College of Cardiology meeting in 2013 showing improved somatic growth with no increase in inpatient resource utilization, and a reduction in reoperation using homemonitoring for interstage children