Skip to main content
SpringerLink
Log in

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

  • Published:
Journal of Digital Imaging Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig 1
Fig 2
Fig 3
Fig 4
Fig 5
Fig 6
Fig 7
Fig 8
Fig 9
Fig 10

Similar content being viewed by others

References

  1. American College of Radiology, National Electrical Manufacturers Association: Digital Imaging and Communications in Medicine DICOM: Version 3.0. Number PS3, 1999

  2. DICOM 3.0 Supplement 30. Waveform Interchange, Nat. Elect. Manufacturers Assoc.: ARC-NEMA, Digital Imaging and Communications, NEMA, Washington D.C., 2000

  3. Open-ECG Web Page. http://www.openecg.net

  4. Health informatics—Standard communication protocol—Computer-assisted electrocardiography. ICS: 35.240.80 IT applications in health care technology; reference number EN 1064:2005+A1, 2007

  5. Brown B, Kohls M, Stockbridge N: FDA-XML data format design specification, revision C. www.openecg.net, 1–27, 2003

  6. Sakkalis V, Chiarugi F, Kostomanolakis S, Chronaki CE, Tsiknakis M, Orphanoudakis SC: A gateway between the SCP-ECG and the DICOM supplement 30 waveform standard. Comput Cardiol 30:25–28, 2003

    Article  Google Scholar 

  7. Schloegl A, Chiarugi F, Cervesato E, Apostolopoulos E, Chronaki CE: Two-way converter between the HL7 aECG and SCP-ECG data formats using BioSig. Comput Cardiol 34:253–256, 2007

    Article  Google Scholar 

  8. Ettinger MJB, Lipton JA, Wijs MCJ, Putten N, Nelwan SP: An open source toolkit in DICOM. Comput Cardiol 35:441–444, 2008

    Google Scholar 

  9. Chiang CC, Yang YC, Tzeng WC, Tzeng WL, Hsieh JC: An SCP compatible electrocardiogram database for signal transmission, storage and analysis. Comput Cardiol 31:621–624, 2004

    Article  Google Scholar 

  10. Hsieh JC: A novel DICOM-based 12-lead electrocardiogram documentary system. J Electrocardiol 40(6):S83, 2007

    Google Scholar 

  11. Hsieh JC, Yu KC, Lo SC, Hung CC, Yeh CH: A novel computerized 12-lead electrocardiograph system for clinical applications. 19th International Conference of Biosignal, Brno, Czech, ID88, 2008

  12. Hilbel T, Brown BD, Bie J, Lux RL, Katus HA: Innovation and advantage of the DICOM-ECG standard for viewing, interchange and permanent archiving of the diagnostic electrocardiogram. Comput Cardiol 34:633–636, 2007

    Article  Google Scholar 

  13. Andrade R, Wangenheim A, Bortoluzzi MK: Wireless and PDA: a novel strategy to access DICOM-compliant medical data on mobile devices. Int J Med Inform 71:157–163, 2003

    Article  PubMed  Google Scholar 

  14. Nakataa N, Suzukib N, Fukuda Y, Fukuda K: Accessible web-based collaborative tools and wireless personal PACS: feasibility of group work for radiologists. Int Congr Ser 1268:260–264, 2004

    Article  Google Scholar 

  15. Tang FH, Law MY, Lee AC, Chan LWC: A mobile phone integrated health care delivery system of medical images. J Digit Imaging 17(3):217–225, 2004

    Article  PubMed  Google Scholar 

  16. Hu F, Jiang M, Xiao Y: Low-cost wireless sensor networks for remote cardiac patients monitoring applications. Wirel Commun Mob Comput 8:513–529, 2008

    Article  CAS  Google Scholar 

  17. Hadzievski L, Boiovic B, Vukcevic V, Belicev P, Pavlovic S, Vasiljevic-Pokrajcic Z, Ostojic M: A novel mobile transtelephonic system with synthesized 12-lead ECG. IEEE Trans Inform Technol Biomed 8(4):428–438, 2004

    Article  Google Scholar 

  18. Giovas P, Papadoyannis D, Thomakos D, Papazachos G, Rallidis M, Soulis D, Stamatopoulos C, Mavrogeni S, Katsilambros N: Transmission of electrocardiograms from a moving ambulance. J Telemed Telecare 4(s1):5–7, 1998

    Article  PubMed  Google Scholar 

  19. Nason GP, Silverman BW: The Stationary Wavelet Transform and Some Statistical Applications, in Lecture Notes in Statistics: Wavelets and Statistics, vol, New York: Springer, 1995, pp. 281–299

    Google Scholar 

  20. Hsieh JC, Hung CC, Lo SC, Yu KC, Yeh CH: The Clinical Application of Stationary Wavelet Transform Based 12-Lead ECG Noise Elimination, 19th International Conference of Biosignal. Brno, Czech, ID87, 2008

  21. Komnakos D, Vouyioukas D, Maglogiannis I, Constantinou P: Performance evaluation of an enhanced uplink 3.5G system for mobile healthcare applications. Int J Telemed Appl 2008:1–11, 2008

    Article  Google Scholar 

Download references

Acknowledgements

The author would like to thank the National Science Council of Taiwan for financially supporting this research under contracts NSC 97-2221-E-155-024 and NSC 95-2221-E-155-087.

Author information

Authors and Affiliations

  1. Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Chung-Li, 32003, Taiwan

    Jui-Chien Hsieh

  2. Department of Computer Science and Engineering, Yuan Ze University, Chung-Li, Taiwan

    Hsiu-Chiung Lo

Authors
  1. Jui-Chien Hsieh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hsiu-Chiung Lo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jui-Chien Hsieh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hsieh, JC., Lo, HC. The Clinical Application of a PACS-Dependent 12-Lead ECG and Image Information System in E-Medicine and Telemedicine. J Digit Imaging 23, 501–513 (2010). https://doi.org/10.1007/s10278-009-9231-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10278-009-9231-7

Key words

Search

Navigation