Abstract
BackgroundDue to the great variability of 12-lead ECG instruments and medical specialists’ interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists’ decision making support in emergency telecardiology.MethodsWe create a new cloud and pervasive computing based 12-lead Electrocardiography (ECG) service to realize ubiquitous 12-lead ECG tele-diagnosis.ResultsThis developed service enables ECG to be transmitted and interpreted via mobile phones. That is, tele-consultation can take place while the patient is on the ambulance, between the onsite clinicians and the off-site senior cardiologists, or among hospitals. Most importantly, this developed service is convenient, efficient, and inexpensive.ConclusionsThis cloud computing based ECG tele-consultation service expands the traditional 12-lead ECG applications onto the collaboration of clinicians at different locations or among hospitals. In short, this service can greatly improve medical service quality and efficiency, especially for patients in rural areas. This service has been evaluated and proved to be useful by cardiologists in Taiwan.
Highlights
Due to the great variability of 12-lead ECG instruments and medical specialists’ interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists’ decision making support in emergency telecardiology
Practice and evaluation of ECG tele-consultation Based on the views of senior cardiologists in Taoyuan Armed Forces General Hospital in Taiwan, a detailed 12-lead ECG report, including the description of the patient’s present symptoms, his/her medical history, and medication records, is crucial for a cardiologist who provides emergency ECG tele-consultation for the consulting clinicians
To facilitate long-distance ECG tele-consultation, this cloud based 12-lead ECG telemedicine service can allow clinicians to store, browse, and interactively edit 12-lead ECG reports via web access while tele-consultation is taking place
Summary
Due to the great variability of 12-lead ECG instruments and medical specialists’ interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists’ decision making support in emergency telecardiology. In Taiwan, most hospitals adopt paper-ECG, which is due to the expenses of vender-specific ECG instruments and ECG viewers, as. From paper-ECG to computerized ECG In 2002, Open-ECG, an international academic organization, promoted the development of computerized 12-lead ECG by providing researchers with technical references of 12-lead ECG data formats, including International Organization for Standardization (ISO) approved Standard Communication Protocol–ECG (SCP-ECG), Food and Drug Administration (FDA) proposed Extensible Markup Language based ECG (XMLECG), and National Electrical Manufactures Association (NEMA) recommended Digital Imaging and Communications in Medicine based ECG (DICOM-ECG) [1,2,3,4]. Several ECG manufactures do not completely adopt the open protocol standards. Instead, they develop vendor-specific ECG data formats and ECG waveform encoding rules. With the help of OPEN-ECG, hospitals can develop 12-lead ECG e-diagnosis instead of paper-ECG by extracting the waveform data from several ECG instruments [5,6]
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