Efforts at cost containment of health-care for congenital heart disease patients in the Northwest

To provide universal access to affordable medical care, efforts to prioritize care, reduce cost, and improve efficiency have grown in importance to pdiatric cardiologists. Significant changes are occurring in the delivery of health-care in this country with varying new strategies being proposed and/or attempted. The potential impact that these changes will have on the practice of pediatric cardiology, on how physicians deliver patient care, and on our patients themselves, is uncertain. The purpose of this article is to review a few of these changes. Areas that we will discuss include: (1) the anticipated changes in medical practice that are likely to occur with the 'Oregon Medicaid Plan'; (2) the impact that the newly emerging field of tele-medicine may have whereby we will have the ability to review echocardiographic and other images from a distance; and lastly; (3) the impact that fetal echocardiography has had and likely will continue to have on pediatric cardiology by allowing for progressively earlier prenatal diagnoses of congenital heart disease.