Facilitating telemedicine: plug and play of different ECG devices
Catherine E. Chronaki
CMI-HTA, Institute of Computer Science, Foundation for Research and Development - Hellas, Heraklion, Greece
A collaboration platform based on instant messaging and presence technology has been employed to implement flexible and adaptable eHealth services. Important features of the platform are eHealth service profiles that entail electronic document templates conforming to HL7's clinical document architecture (CDA), the electronic signing of clinical objects using smart cards, and the use of Object Management Group's (OMG) person identification service (PIDS) to interoperate with other clinical information systems. The platform is also characterized by the use of medical device components that currently support real-time and/ or store-and-forward access to spirometry examinations, medical imaging, vital signs, ECG, and auscultation data.
A wide variety of medical devices have been integrated to the eHealth station. Each device component has been wrapped up as one or more ocx controls, which can be embedded in a web page using javascript. These controls can be downloaded on demand from the Internet and configured in the context of different eHealth services.
An electrocardiograph that allows continuous ECG recording can be used both in store-and-forward and in real-time mode. In all cases, instant messaging and presence facilitates communication among the participants. The healthcare professional close to the patient prepares the patient and starts recording the cardiac activity, while at the same time can request the storage 10 sec snapshots in the shared clinical folder according to the SCP-ECG standard. In the meantime, instant messaging and presence is used to notify an appropriate expert and invite him/her to join a real-time session. When the expert accepts the invitation the remote station automatically starts receiving & displaying the signal. At this time, only two participants may concurrently view the ECG in real-time. There are plans to extend the real-time ECG component to support multicasting.
Different models of electrocardiographs have been integrated to the eHealth station. However, there is a proliferation of standards some proprietary and some open for electrocardiographs. In Europe, the accepted standard is SCP-ECG and the eHealth station supports it. For electrocardiographs that do not support the standard, specialized software makes the appropriate conversion. In our demonstration today we will show interoperability between ECGs acquired by Cardiette Excel 106 and 10 sec snapshots of continuous ECG activity recorded by a Cardio Control Cardioperfect device. In the first case, the device stores the ECG record directly in SCP-ECG and we just update the patient data, while in the second case we take the signal snapshot and convert it to SCP-ECG adding patient demographics.
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