Electronic patient record, expert system and mobile monitoring in Cardio.net project

• Autorzy: Rudowski R. , Grabowski M. , Sierdziński J. , Guć M.
• Języki publikacji: EN

Abstrakty

EN

Cardio.net project is aimed at the implementation of the prototype system of telecardiology in Mazovia and Pomerania Regions of Poland. It is planned as a tool to reduce the time from the onset of symptoms to the cardiological intervention, which can significantly reduce the mortality of patients with the acute coronary syndromes (ACS). The system will enable teleconsultations, from the reference centers to the regional hospitals, regarding the need for invasive cardiological intervention. If there is such a need then the patient will be transported to the reference center. The Cardio.net tasks include the design of telecommunication infrastructure, incorporating data transmission standards HL7, DICOM, work on the security and safety of the system, the design of Electronic Patient Record (EPR), uniform archive of EPR's and also the expert system. The EPR consist of two types of forms: a) personal data forms, b) forms supporting the physician work (case history, diagnosis, physical examination, the clinical course of hospitalization, additional tests and drugs). The tools used for creating EPR and archive of EPR's were PHP, Java Script, XML and MySQL. The risk stratification and therapeutic decision making in ACS are the main tasks of the expert system. There are two main therapeutic strategies: early invasive versus conservative. The chosen strategy depends on several factors. The expert system has been verified on the archival data of 147 patients with ACS. In 127 (86%) the expert system suggested the same strategy as applied by the cardiologist. In conclusion: uniform EPR and archive of EPR's give a chance of improving the quality of the cardiological care due to teleconsultations performed directly by specialists or indirectly by the expert system. Mobile monitoring and alerting can decrease the time from the onset of symptoms to the therapeutic intervention thus improving the patients safety,

Słowa kluczowe

EN

telecardiology; acute coronary syndrome; medical informatics

PL

telekardiologia; choroba wieńcowa; informatyka medyczna

• Wydawca: Nałęcz Institute of Biocybernetics and Biomedical Engineering of the Polish Academy of Sciences ; Elsevier
• Czasopismo: Biocybernetics and Biomedical Engineering
• Rocznik: 2004
• Tom: Vol. 24, no. 1
• Strony: 61--71
• Opis fizyczny: Bibliogr. 15 poz., rys., tab.

Twórcy

autor

Rudowski R.

• Departament of Medical Informatics, Medical University of Warsaw, Central Clinical Hospital, Banacha 1A, 02-097 Warsaw, Poland; Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland

autor

Grabowski M.

• Departament of Medical Informatics, Medical University of Warsaw, Central Clinical Hospital, Banacha 1A, 02-097 Warsaw, Poland; Cardiology Clinic, I-Faculty of Medicine, Medical University of Warsaw, Central Clinical Hospital, Warsaw, Poland

autor

Sierdziński J.

• Departament of Medical Informatics, Medical University of Warsaw, Central Clinical Hospital, Banacha 1A, 02-097 Warsaw, Poland

autor

Guć M.

• Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland

Bibliografia

• [1] Fogliardi R., Frumento E., Rincon D., Vinas M.A., Fregonara M.: Telecardiology: Results and perspectives of an operative experience. J Telemed Telecare 2000, 6 Suppl 1, 162-164.
• [2] Sable C.: Telecardiology: potential impact on acute care. Crit C Med 2000, 29 (8 Suppl), N 159-65.
• [3] Sjogren L.H., Schwieler A., Tornquist H.: Evaluation of videoconferences in telecardiology. Proc of VII th Int Conf TELEMED 99, London 1999, 211.
• [4] Pribik V., Grunfeldova H., Hanzlicek P, Peleska J., Zvarova J.: Czech National Data Standards Implementation in ORCA Electronic Patient Record in Cardiology. In.: Medical Infobahn for Europe. Proc of MIE 2000 and GMDS 2000, Hasman A et al. (Eds.), 6.
• [5] Homepage; PHP; http://www.php.net.
• [6] Homepage Apache; http://www.apache.orp/dist/.
• [7] Tim Converse, Joyce Park „Biblia PHP 4”.
• [8] Homepage MySQL; http://www.mvsql.com.
• [9] A Beginner’s Guide to JavaScript; http://www.isguide.simplenet.com.
• [10] Elliotte Rusty Harold „XML Księga eksperta”.
• [11] Homepage HL7; http://www.hl7.de/.
• [12] Braunwald E., et al.: ACC/AHA Guideline Update for the Management of Patients With Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction, American College of Cardiology and the American Heart Association, Inc. 2002.
• [13] Bertrand M.E. Simoons M.L., Fox K. et al. Management of Acute Coronary Syndromes. Acute Coronary Syndromes without persistent ST segment elevation, European Heart Journal 2000, 21, 1406-1432.
• [14] Lawrance J.: Expert Systems. In: Introduction to neural networks. Design theory and applications. California Scientific Software Press, Nevada City 1994: 39-50.
• [15] CLIPS - Reference Manual Volume I Basic Programming Guide. 1998.