Skip to main content
Log in

Healthcare-based on Cloud Electrocardiogram System: A Medical Center Experience in Middle Taiwan

  • Systems-level quality improvement
  • Published:
Journal of Medical Systems Aims and scope Submit manuscript

Abstract

Electrocardiogram (ECG) as one of the best methods to measure irregular heartbeats is a dispensable method for doctor to diagnose Acute Myocardial Infarction (AMI) patients. Most medical centers in Taiwan implement the reduction of Door to Balloon (D2B) time, which is defined as the time interval starting when an Acute–Myocardial-Infarction patient arrives at the Emergency Department, and ending when a catheter guide wire crosses the culprit lesion as the acute-myocardial-infarction treatment on the patient in the cardiac catheterization room. Generally, when a patient with acute-chest pain is sent into a hospital (always to Emergency Department), the hospital will collect his/her ECG which needs to be evaluated by a cardiologist to ensure that the patient really has Acute Myocardial Infarction. Then the medical workers deliver the patient to the cardiac catheterization room to operate balloon angioplasty. In previous years, the cardiologist must utilize a PC to connect to the Intranet of the hospital and employ a special PACS (Picture Archiving and Communication System) image browser before he/she can check the patient’s ECG. But this will prolong the D2B time since the doctor may stay outdoors and he/she needs some time to find a PC and network. Of course, if the PC has not installed the PACS image browser, the doctor has to download and install it. Consequently, the D2B time should be worsened, thus possibly impacting the patient’s life. Therefore, in this paper, we introduce a Cloud-based Electrocardiogram System, with which cardiologists can directly utilize their smart phones to browse the patient’s ECG so as to shorten the D2B time. This system has been online in a medical center in middle Taiwan for more than one year. The shortened D2B time is longer than 10 min, i.e., receiving fine results.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Wiki, service quality, https://en.wikipedia.org/wiki/Service_quality

  2. Taiwan Ministry of Health and welfare News, http://www.mohw.gov.tw/news/572256044

  3. Wiki, Killip class, https://en.wikipedia.org/wiki/Killip_class

  4. Wiki, healthcare industry, https://en.wikipedia.org/wiki/Healthcare_industry

  5. dicom.nema.org, DICOM TAG: http://dicom.nema.org/medical/dicom/current/output/pdf/part06.pdf, pp. 23–138

  6. Wiki, DICOM. https://en.wikipedia.org/wiki/DICOM

  7. NEMA: http://dicom.nema.org/

  8. Wiki, Electrocardiogram: https://en.wikipedia.org/wiki/Electrocardiography

  9. CC/AHA guideline: http://circ.ahajournals.org/content/110/5/588.figures-only

  10. Menees, D.S., Peterson, E.D., Wang, Y., Curtis, J.P., Messenger, J.C., Rumsfeld, J.S., and Gurm, H.S., Door-to-balloon time and mortality among patients undergoing primary PCI. N. Engl. J. Med. 369(10):3, 2013.

    Article  Google Scholar 

  11. Taiwan Ministry of Health and Welfare News, http://www.mohw.gov.tw/news/531652300

  12. Wiki, VPN, https://en.wikipedia.org/wiki/Virtual_private_network

  13. Zhang, X. S., Leu, F. Y., and Yang, C. W., Healthcare based on Cloud Electrocardiogram System: A Medical Center Experience in Middle Taiwan. The International Conference on Innovative Mobile and Internet Services in Ubiquitous Computing, July 2017, pp. 473–482.

  14. Bokhari, M. U., Shallal, Q. M., Tamandani, Y. K., Cloud Computing Service Model: A Comparative Study, pp 1

  15. Wiki, Cloud computing architecture, https://en.wikipedia.org/wiki/Cloud_computing_architecture

  16. Wiki, Mobile Computing. https://en.wikipedia.org/wiki/Mobile_computing

  17. Wiki, Mobile Commerce. https://en.wikipedia.org/wiki/Mobile_commerce

  18. Wiki, Health Information System, http://www.mohw.gov.tw/news/572256044

  19. Kirn, S., Herzog, O., Lockemann, P., and Spaniol, O., Multiagent Engineering-Theory and Applications in Enterprises, 1 st ed. Springer: Berlin, 2006, pp. 303-304.

  20. Bureau of Primary Health Care, Progress Note, https://bphc.hrsa.gov/archive/technicalassistance/resourcecenter/services/patientprogressnoteprotocol.pdf

  21. Centers for Disease Control and Prevention, Vital Signs, https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6135a3.htm

  22. Wiki, e-Health, https://en.wikipedia.org/wiki/EHealth

  23. Wiki, m-Health, https://en.wikipedia.org/wiki/MHealth

  24. Wiki, Holter-Monitor, https://en.wikipedia.org/wiki/Holter_monitor

  25. IEEE, Internet Of Things (IoT), http://iot.ieee.org/images/files/pdf/IEEE_IoT_Towards_Definition_Internet_of_Things_Revision1_27MAY15.pdf

  26. Saldarriada, A. J., Pérez, J. J., Restrepo, J., and Bustamante, J., A mobile application for ambulatory electrocardiographic monitoring in clinical and domestic environments. Pan American Health Care Exchanges (PAHCE), 2013, Medellin, Colombia, pp. 2-4.

  27. Chen, H., Xiang, D., Qin, W., Zhou, M., Tian, Y., and Liu, J., A study of regional cooperative emergency care system for ST-elevation myocardial infarction patients based on the Internet of Things. IEEE14th International Conference e-Health Networking, Applications and Services (Healthcom), 2012, Chengdu, China, pp. 2–3.

  28. Chatzigiannakis, I., Valchinov, E. S., Antoniou, A., Kalogeras, A., Alexakos, C., and Konstantinopoulos, P., Advanced observation and telemetry heart system utilizing wearable ECG device and a cloud platform. IEEE Symposium on Computers and Communication (ISCC), 2015, Larnaca, Cyprus, pp. 3–6.

  29. Taddei, A., Paradossi, U., Rocca, E., Carducci, T., Mangione, M., Dalmiani, S., Laws, E., Marchi, M., Badiali, B., and Berti, S., Information system for assessing health care in acute myocardial infarction. Computing in Cardiology (CinC), 2012, Krakow, Poland, pp. 1–3.

  30. Wang, C. S., Liu, C. W., and Huang, Y. C., ECG monitoring system in vehicles. RF and Wireless Technologies for Biomedical and Healthcare Applications (IMWS-BIO), IEEE MTT-S 2015 International Microwave Workshop Series, 2015, No. 11, Taipei, Taiwan, pp. 1–2.

  31. Wiki, Framingham Heart Study, https://en.wikipedia.org/wiki/Framingham_Heart_Study

  32. Framingham Heart Study, https://www.framinghamheartstudy.org/

  33. Schatzkin, A., Cupples, L.A., Heeren, T., Morelock, S., and Kannel, W.B., Sudden death in the Framingham Heart Study. Differences in incidence and risk factors by sex and (coronary) disease status. Am. J. Epidmiol. 120(6):1–2, 1984.

    Google Scholar 

  34. Wiki, Timeline of Myocardial Infarction Pathology, https://en.wikipedia.org/wiki/Timeline_of_myocardial_infarction_pathology

  35. Turillazzi, E., Paolo, M.D., Neri, M., Riezzo, I., and Fineschi, V., A theoretical timeline for myocardial infarction: Immunohistochemical evaluation and western blot quantification for interleukin-15 and monocyte chemotactic protein-1 as very early markers. J. Transl. Med. 12(188):7, 2014.

    Google Scholar 

  36. PTCA: https://medlineplus.gov/ency/anatomyvideos/000096.htm

  37. Ogiela, L., Cognitive Computational Intelligence in Medical Pattern Semantic Understanding. In: Guo, M. Z., Zhao, L., Wang, L. P., (Eds.), International Conference on Natural Computation (ICNC 2008). Vol. 6. Peoples R China: Jian, 2008, pp. 245-247.

  38. Ogiela, L., Semantic analysis in cognitive UBIAS & E-UBIAS systems. Comput. Math. Appl. 63(2):378–390, 2012.

    Article  Google Scholar 

  39. Ogiela, M.R., and Ogiela, L., Cognitive Informatics in Medical Image Semantic Content Understanding. Commun. Comput. Inform. Sci. 78:131–138, 2010.

    Article  Google Scholar 

  40. Castiglione, A., Pizzolante, R., De Santis, A., Carpentieri, B., Castiglione, A., and Palmieri, F., Cloud-based adaptive compression and secure management services for 3D healthcare data. Futur. Gener. Comput. Syst. 43-44:120–134, 2015. https://doi.org/10.1016/j.future.2014.07.001.

    Article  Google Scholar 

  41. Leu, F. Y., Ko, C. Y., You, I., Choo, K. K. R., Ho, C. L., A smartphone-based wearable sensors for monitoring real-time physiological data. Comput. Electr. Eng. 2017. https://doi.org/10.1016/j.compeleceng.2017.06.031.

  42. Castiglione, A., Pizzolante, R., Esposito, C., De Santis, A., Palmieri, F., and Castiglione, A., A collaborative clinical analysis service based on theory of evidence, fuzzy linguistic sets and prospect theory and its application to craniofacial disorders in infants. Futur. Gener. Comput. Syst. 67:230–241, 2017. https://doi.org/10.1016/j.future.2016.08.001.

    Article  Google Scholar 

  43. Wiki, EMR, https://en.wikipedia.org/wiki/Electronic_health_record

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fang-Yie Leu.

Ethics declarations

Conflict of interest

Authors declare no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

This article is part of the Topical Collection on Systems-level quality improvement

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, XS., Leu, FY., Yang, CW. et al. Healthcare-based on Cloud Electrocardiogram System: A Medical Center Experience in Middle Taiwan. J Med Syst 42, 39 (2018). https://doi.org/10.1007/s10916-018-0892-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10916-018-0892-y

Keywords

Navigation