The Clinical Application of a PACS-Dependent 12-Lead ECG and Image Information System in E-Medicine and Telemedicine

• Published in: Journal of digital imaging Vol. 23; no. 4; pp. 501 - 513
• Main Authors: Hsieh, Jui-Chien, Lo, Hsiu-Chiung
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.08.2010; Springer Nature B.V
• Subjects: Archiving; Automatic Data Processing - methods; Electrocardiography - methods; Emergencies; Extensible Markup Language; Humans; Imaging; Information Storage and Retrieval - methods; Information systems; Instrumentation; Medical Records Systems, Computerized; Medicine; Medicine & Public Health; Radiology; Radiology Information Systems - organization & administration; Signal Processing, Computer-Assisted; Software; Telecommunications - instrumentation; Telemedicine; Telemedicine - instrumentation; Telemedicine - methods; XML; ECG; telemedicine; PACS; DICOM
• ISSN: 0897-1889; 1618-727X
• DOI: 10.1007/s10278-009-9231-7

This study presents a software technology to transform paper-based 12-lead electrocardiography (ECG) examination into (1) 12-lead ECG electronic diagnoses (e-diagnoses) and (2) mobile diagnoses (m-diagnoses) in emergency telemedicine. While Digital Imaging and Communications in Medicine (DICOM)-based images are commonly used in hospitals, the development of computerized 12-lead ECG is impeded by heterogeneous data formats of clinically used 12-lead ECG instrumentations, such as Standard Communications Protocol (SCP) ECG and Extensible Markup Language (XML) ECG. Additionally, there is no data link between clinically used 12-lead ECG instrumentations and mobile devices. To realize computerized 12-lead ECG examination procedures and ECG telemedicine, this study develops a DICOM-based 12-lead ECG information system capable of providing clinicians with medical images and waveform-based ECG diagnoses via Picture Archiving and Communication System (PACS). First, a waveform-based DICOM-ECG converter transforming clinically used SCP-ECG and XML-ECG to DICOM is applied to PACS for image- and waveform-based DICOM file manipulation. Second, a mobile Structured Query Language database communicating with PACS is installed in physicians’ mobile phones so that they can retrieve images and waveform-based ECG ubiquitously. Clinical evaluations of this system indicated the following. First, this developed PACS-dependent 12-lead ECG information system improves 12-lead ECG management and interoperability. Second, this system enables the remote physicians to perform ubiquitous 12-lead ECG and image diagnoses, which enhances the efficiency of emergency telemedicine. These findings prove the effectiveness and usefulness of the PACS-dependent 12-lead ECG information system, which can be easily adopted in telemedicine.