Although designations of the City ECG Archive and of the Remote ECG Description System are different
(the Archive is designed to access previous ECGs with a view to a more reliable description of the current ECG, while the Remote Description solves the issue of the lack of doctors
specializing in functional diagnostics and consulting ambulance crews), the both functions have similar compositions:
a server to store ECGs;
server software (maintenance of the Archive, the Dispatcher software application);
a range of the Myocard equipment to record ECGs (the Myocard-12 and Myocard-Holter stationary systems and the Myocard-12 portable systems).
Devices of those systems can be connected to the server in any way (via LAN, via a modem through telephone lines, via GPRS internet, or via Wi-Fi, Yota, etc.);
several computers of the doctors specializing in functional diagnostics (consultants);
several computers for the doctors to see ECGs without editing (cardiology, resuscitation, etc.).
City ECG Archive Designation
A unified archive of ECGs of the inhabitants of a town or city is intended to urgently access a patient’s previous ECGs regardless of his or her place of residence within this town or city.
The City ECG Archive provides for:
ECGs to be sent automatically to server from all the locations connected to Archive;
A dynamic analysis of a series of ECGs by means of Myocard-12 devices regardless of the place where the latest ECG was recorded (without a unified archive a dynamic analysisis performed at each work station within only the local database);
Access by doctors specializing in functional diagnostics to the previous ECGs to visually compare ECGs when describing them. This is the most demanded function of the system (in our city, each doctor specializing in functional diagnostics addresses the archive 50 times a day on average);
Access by ambulance paramedics to the previous ECGs to visually compare them;
A possibility for a doctor specializing in functional diagnostics who is on duty to give urgent advice to anyMyocard-12 work station (e.g. in a village hospital) or to an ambulance crew.
Remote Standard and Daily ECG Description
The use of internet technologies makes this task very simple. Software interfaces «Myocard-12» and
«Myocard-Holter» have the button «Send for consulting». This button allows for displaying a list of consulting doctors in your area who are online «On-Line».
You can choose a particular doctor or just any one. Then the ECG is sent to server. At the server, a dispatching software «distributes» incoming ECGs among consulting doctors or sends a particular ECG to a particular doctor.
The doctor should have software installed on the computer «the Consultant». Having received an ECG, it alerts the doctor by a sound signal and a red line.
All ECGs are divided into planned and emergency ones. If the doctor is away for a defined time, an emergency ECG is forwarded to another consultant. A doctor can analyze an ECG for a few minutes; therefore, after the doctor has begun working, the following message is sent to the client’s PC:"Dr. [surname] started to analyze ECG".
When describing a standard ECG, the doctor looks at the patient’s earlier ECGs. The doctor’s conclusion is based on the one made by the computer, which saves a lot of time.
The "Administrator" software is also available; it monitors the statuses of consultants, clients and queues and displays different statistical data on consultations provided.
Advantages:
Unlike in the case with systems with sound modulation:
- ECG transmission does not cause additional interfering signals; the ECG can be used for computer diagnostics.
- The transmission is performed at the press of a button within one second,i.e.it requires no additional actions either at the sending end or at the receiving one.
At the time of transmission, an ECG is automatically recorded in the Town or City ECG Archive or in the regional one as the patient’s full name, sex, date of birth and other identification data are transmitted too;
Only our system allows for a dynamic computer analysis based on «a series of ECGs». This greatly helps a consulting doctor to describe the current ECG thus raising the quality of the doctor’s conclusion;
The doctor’s conclusion is sent back in the text format. The recipient can print it out and sign it based on the electronic signature.
Available are: several modes to send data for consulting (to a particular doctor or via automatic distribution by the Dispatcher software), classification of ECGs into planned and Cito ones, and automatic forwarding of Cito ECGs to another consultant.
All these arrangements do not require continuous tension from the doctor (the doctor can go away for a while) without leaving the clients unattended.
It is possible to give advice from wherever Internet access is available, even from home.
A wide range of data can be transmitted for remote characterization:
- a standard 12-lead ECG;
- 1-, 2- and 3-lead ECGs from household cardio analyzers and cardio recorders;
- daily ECG monitoring data;
- daily ABP monitoring data;
Ambulance Crew Support
Before sending out an ECG, an ambulance paramedic can dictate a message containing the patient’s complaints, anamnesis, etc.
This voice message is sent to the doctor together with the ECG. If the doctor has any questions, he/she can call the client on a mobile telephone for clarifications.
As doctors and ambulance paramedics are both able to read ECGs, a very high demand appeared for the option that allows for viewing the previous ECGs in place.
The doctor presses «the Archive» button on the netbook or on his/her PDA, and the patient’s ECGs and their dates are listed on the screen.
The doctor chooses the required ECG and can see the development himself/herself.
Now we offer mobile Internet in 2 options (a netbook with a built-in modem or a PDA) and 2 options for ECG recording instrumentation (a portable ECG recorderor a cardio module).
Specially for ambulance crews, we developed an ECG recorder with netbook functions, i.e. with Windows and Internet.
Configurations
We can offer several modes of use of our technologies. They are as follows, from simple to complicated ones:
1. Telecommunication assurance.
By means of this option, we can connect your ECG room with your doctor if the latter is away.
All the communication will be effected via the Internet Cardiocentre’s server ( www.myocard-msc.ru)
This option can be applied for:
for private clinics where a doctor specializing in functional diagnostics cannot be present in the clinic all day long, but can describe ECGs from other locations,
for hospitals that have remote subdivisions where there are no doctors specializing in functional diagnostics,
for ambulance crews.
2. Consulting by ECGs
We can offer to private clinics to have standard and daily ECGs described by doctors from the Internet-Cardiocenter.
For that you can choose consulting doctors, for example, ones from your regional hospital:
3. Patient consulting
Your private clinic or cardiocenter can purchase a small lot of home cardioanalyzers. Then you can lend those instruments to your patients.
When your patients feel bad, they will record their ECGs at home and send them to their doctor. Please see the Home Cardioanalyzer section for details.
4. Creating a City ECG Archive with the full telemedicine functionality
Such projects are ordered by district hospitals, by medical units of huge companies that constitute local economic mainstays, and by regional healthcare ministries.
Unlike in the first option, all the communication will be performed via your server. Your server will also host an ECG Archive (of a town, city, district or region).
The Archive is addressed by doctors specializing in functional diagnostics when describing ECGs, doctors from hospital admission departments, ambulance doctors visiting their patients, and doctors from other hospital departments.
All the functionalities of the foresaid options are still available.
According to our estimations, the creation of Regional ECG Consulting Centers is the most demanded objective in telemedicine in general: costs are low, the benefit is huge.
In each region, there are from a few dozens to a few hundreds of village and district hospitals that do not have doctors specializing in functional diagnostics.
By using our technologies, such hospital will receive remote descriptions not only for standard ECGs, but also for daily ECGs and ABPs, which they cannot afford at the moment.
The largest project was implemented in Sevrdlovskaya oblast (the Yekaterinburg region). In this region, ECGs are sent from 273 hospitals and paramedic-and-midwife stations to 10 consulting centers,
with a unified regional archive and the main consulting center located in the Urals Cardiology Institute.
In the field of digital technologies, Myocard is the most well-proved technology in Russia. The first City Archive was launched (in the town of Sarov) back in 2006.
Among the federal structures, our first customers were: State-Financed Clinical Hospital no. 85 of the Federal Medical and Biological Agencyof Russia, State-Financed Scientific & Clinical Center of the Federal Medical and Biological Agency of Russia,
State-Financed Polyclinic no. 1 of the Russian President’s Administration with its 10 remote medical units, the Russian State Bank, the Russian Railways Joint-Stock Company, hospitals in such towns and cities as Sergiev Posad, Kazan, etc.
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