title: The clinical application of a PACS-dependent 12-lead ECG and image information system in E-medicine and telemedicine.
abstract: 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.
authors.affiliation: Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Chung-Li, 32003, Taiwan. jchsieh@saturn.yzu.edu.tw
authors.forename: Jui-Chien
authors.initials: JC
authors.lastname: Hsieh
authors.forename: Hsiu-Chiung
authors.initials: HC
authors.lastname: Lo
mesh_terms: D004562:Electrocardiography / Q000379:methods*; D001330:Electronic Data Processing / Q000379:methods; D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods*; D016347:Medical Records Systems, Computerized; D011873:Radiology Information Systems / Q000458:organization & administration; D012815:Signal Processing, Computer-Assisted; D012984:Software; D013685:Telecommunications / Q000295:instrumentation; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*