|Standard of Care Strategy||At-Distance Consultation and Echocardiographic Strategy|
|Initial patient visit at PHC||Patient examination by the GP; the GP decides to refer for specialist consultation||Patient examination by the GP; the GP decides to refer for specialist consultation|
|Referral after randomization||Lycksele hospital approached for cardiologist consultation and echocardiography||Skellefteå Hospital appointment secured for remote echocardiography and cardiology consultation∗|
|Appointment secured||Patients scheduled for visit to the Lycksele hospital cardiologist consultation|
|Ultrasound examination and cardiology consultation||Echocardiogram and cardiology consultation at the Lycksele hospital||Same-day remote echocardiography examination followed by cardiology consultation in the presence of the GP, patient, and sonographer. CRF signed off by the GP at the PHC with complete decision and plan of management∗|
|Consultation and echocardiography report available to GP||Consultation and echocardiographic results sent back to the GP|
|Plan of care completed||CRF signed off by the GP at the PHC with complete decision and plan of management|
CRF = case report form; GP = general practitioner; PHC = primary healthcare center.
↵∗ Events of substantial time-saving.