Viewpoint

Professor Peter W. MacFarlane,
Chair WG Computers in Cardiology, European Society of Cardiology (ESC)

Introduction

OpenECG is a European Union Project funded from the Information Society Technologies (IST) Programme, which commenced 1st July, 2002, and which is supported for two years. There are five partners in the consortium, namely the Institute of Computer Science which is part of the Foundation for Research and Technology, Hellas (FORTH) based in Heraklion, Crete, the Danish Centre for Health Telematics based in Odensk, Biosigna from Hannover, Germany, the Institute of Clinical Physiology, CNR, Pisa, Italy and RGB Medical Devices from Madrid, Spain.

Essentially, the aim of the OpenECG project is to regenerate interest in the SCP-ECG standard which was initially a spin off from the European Union funded Common Standards for Electrocardiography (CSE) Project. SCP-ECG developed into a European norm ENV1064 and ultimately became an American AAMI-EC71 standard. The fundamental principle of SCP-ECG is to allow the transmission of ECGs recorded in one manufacturer's device to be received and decoded by another manufacturer's device, whether it be a central ECG management system or a more simple facility.

Workshop

The workshop consisted of a number of presentations, some of which related to computer analysis of ECGs while others were essentially progress reports from a variety of interesting European projects, all of which incorporated ECG recording in one way or another, from one lead to twelve leads. Industry, academia and the user community were all represented.

There were a number of small working group sessions, at which the views of the different parties were interchanged. There were open debates, where some frank questions were asked, and answers were sometimes teased out and sometimes were simply not available at this stage.

Aims

The host organisation for the project is FORTH to which the project leader Catherine Chronaki belongs. She set out some hopes for the two year project. These included:

Promotion of the SCP-ECG standard
Establishment of an ECG portal through which information and implementation about SCP-ECG could be obtained
Web based discussion groups on computerised ECG standards
A help desk for answering queries in relation to the implementation of SCP-ECGs.
The possibility of offering conformance testing to indicate that a particular implementation of SCP-ECG met a required level
The establishment of an Advisory Board who could provide a reference platform for SCP-ECG etc.

Discussion

Some of the points which emerged during the discussions were that:

The FDA had its own initiative relating to an XML based protocol for transmission of ECGs particularly in relation to drug studies. Christoph Zywietz assured the meeting that he had been advised by the FDA that this standard was purely and solely for transmission of ECGs in a digital format to enable the FDA to hold a database of ECGs recorded in the development and evaluation of new drugs. It was claimed that major manufacturers were already working on implementing this protocol but on the other hand it was accepted they had to follow this up from the point of sheer commercial necessity.
There was some concern over the original concept of an all embracing Advisory Board but this was modified so that a clear remit would be set out before a limited number of individuals was invited to join a Board that would oversee the evolution of the project.
There was concern among manufacturers that they simply could not be all things to all men and handle SCP compatible ECGs coming from any device from every manufacturer. The only solution to this, it was agreed, was to restrict the so called degrees of freedom within SCP, i.e. there had to be a very tight protocol such as for lossless data compression of the ECG and little reliance on the "manufacturer specific" component of the protocol. Christoph Zywietz volunteered to co-ordinate this matter.

Other innovative concepts included a competition for the development of software tools in relation to SCP. For example, an open source ECG viewer was one example of something that might be developed. A competition would be announced shortly with a first prize of 6,000 Euros, second prize 3,000 Euros and third prize 1,000 Euros. Details of the competition would appear within the web portal.

Participants and any others who wish to join the open ECG project formally were encouraged to register on-line via the OpenECG web portal.

Conclusions

There was a feeling of optimism at the end of the meeting that the possibility of achieving some degree of collaboration among major manufacturers was higher than might have been expected at the outset, despite the FDA XML project. More detailed discussions would have to be held, either round the table or via the web, by small groups interested in particular aspects of modifying the SCP-ECG definitions in order to take matters forward. Although there are many difficulties, the most important aspect in this commentator's opinion is the establishment of a type of conformance testing which would effectively "certify" that an SCP-ECG implementation had been achieved to a certain level. In the short term, this would certainly not be any form of official approval but it would be a starting point.

The organisers should be congratulated on their initiative in trying to rejuvenate SCP-ECG and thanked for organising an interesting meeting in the Eastern Mediterranean just as summer was beginning to fade away. Indeed, as the conference ended, the clouds rolled in, the rain drops appeared and the storm clouds gathered... ...

Peter W. Macfarlane
University of Glasgow

October 18, 2002

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