Evaluation of international standards for ECG-recording and storage for use in tele-medical services

This report is written to clarify which of the international standards for ECG recordings that can be used in tele-medical services, where the recordings should be transmitted by wireless telecommunication facilities and finally stored as information integrated into the patients Electronic Health Record (EHR). Some principals for recording, transmission and storage of digital vital signs parameters are highlighted and important aspects of wireless communication of recorded signals from biomedical sensors are described, in order to understand the significance and differences in the storing formats to be used. Even if most of the relevant standards are not yet ratified (the last meeting in ISO TC 251 WH6 was held in October 2005), the actual international standards SCP-ECG, MFER, FDAXML and DICIOM are defined and already widely adopted. In this report, these standards are briefly described and evaluated with respect to possible use in tele-medical services, and recommendations are given in order to obtain a reliable and secure communication solution. Requirements for integration of the ECG file formats into the EHR are briefly described, and it is given some recommendations for actual standards to be used in future solutions

A Case Study of Technology Use and Information Flow at a Danish E-clinic

Author´s accepted manuscript (postprint).© 2020 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.There is an urgent call from health organizations, health professionals and health authorities to re-design care delivery for patients with chronic conditions and multimorbidities. The research project 3P- Patients and Professionals in Productive Teams aims to study health care services that are run with different patient-centered teamwork models. In this context, a case study was made of an E-clinic in Denmark, with a focus on the technology use and information flow in a patientcentered clinical care context. Qualitative methods were applied with observations and interviews with key informants. The results showed that information flow worked well in a patient-centered care perspective, even though the technology was a standalone system for the E-clinic and with limited interoperability with other health care providers.acceptedVersio

Patient Experiences and Digital Involvement in Patient-centred Care Models

The provision of individualised treatment and care from health care services to patients with chronic conditions and multi-morbidities is under pressure because of an increasing elderly population. There is a need for services that are: 1) person-centred, 2) integrated and 3) proactive, and supported by digital technology. The research project 3P- Patients and Professionals in Productive Teams aims to study different patient-centred teamwork models in Norway and Denmark. This paper presents a study on patients’ experiences and digital involvement in patient-centred care teams. Qualitative research methods were applied with interviews and demonstrations of technology use made at patient’s homes. The results showed that the patients were satisfied with the patient-centred service models and had an increased feeling of safety. A constraint was information sharing between the patient-centred health care team and the patients. Most of them did not have access to read own medical information and mainly verbal information was shared between the patients and the health providers.publishedVersionPaid Open Acces

An Evaluation of Telemedicine Systems in Patient-centred Care Teams

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Remote ECG Monitoring by ECG247 Smart Heart Sensor

Background. Heart rhythm disorders are common and may be associated with serious complications. The quality of the ECG signal is crucial to detect and classify arrhythmias. Most available devices for assessment arrhythmias do not allow for remote monitoring. The Norwegian ECG247 Smart Heart Sensor is a new remote patch monitor developed to simplify the assessment of arrhythmias. This study was aimed at evaluating the quality of the ECG signal from the ECG247 Smart Heart Sensor compared to standard 12-lead ECG. Methods. ECG recordings with ECG247 Smart Heart Sensor and a standard 12-lead ECG recorder were performed in 97 volunteers at Sorlandet Hospital, Arendal, Norway, in 2019. All ECGs were analysed by two independent cardiologists. Results. A total of 97 participants (53% men, age 48 (±14) years) were included in the study. The ability for both systems to use recorded ECG data for arrhythmia detection was good (100%). The quality of the P-wave (mean score 1.1 vs. 1.5) and the QRS complex (mean score 1.0 vs. 1.0) from the ECG247 Smart Heart Sensor and that from the 12-lead ECG were comparable (scale: 1: extremely good, 9: not accepted). Noise artefacts were a minor issue in all recordings. Conclusions. The ECG quality from the ECG247 Smart Heart Sensor was comparable to the ECG quality from the standard 12-lead ECG. The ECG247 Smart Heart Sensor may enable easy and remote diagnostics of heart rhythm disorders. This trial is registered with NCT04700865.publishedVersio

Design Requirements for a Patient Administered Personal Electronic Health Record

Published version of a chapter in the book: Biomedical engineering, trends in electronics, communications and software. Intech, 2011 Open Acces

Evaluation of the Technology Use in an Inter-disciplinary Patient-centered Health Care Team

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eHealth-extended Care Coordination: Development of a Collaborative System for Inter-municipal Dementia Teams-A research project with a user-centered design approach

-In Norway, a health reform was recently adopted to improve continuity of care. Services that were carried out in hospitals were transferred to municipalities. Small and medium size municipalities have established inter-municipal cooperation to provide specialized services across borders. The research project eHealth-extended Care Coordination studied the inter-municipal cooperation for assessment of dementia, identifying a need for improved communication and coordination. This paper presents the development process of a collaborative information system for dementia assessment using a user-centered design approach. Mixed methods, such as observations, semi-structured interviews and questionnaire, were used for data collection. The results showed that end-user involvement usefully informed the development. The information system effectively supported collaborative work and shared access to information for the inter-municipal team

Clinical evaluation of a wireless ECG sensor system for arrhythmia diagnostic purposes

In a clinical study, a novel wireless electrocardiogram (ECG) recorder has been evaluated with regard to its ability to perform arrhythmia diagnostics. As the ECG recorder will detect a "non-standard" ECG signal, it has been necessary to compare those signals to "standard" ECG recording signals in order to evaluate the arrhythmia detection ability of the new system. Simultaneous recording of ECG signals from both the new wireless ECG recorder and a conventional Holter recorder was compared by two independent cardiology specialists with regard to signal quality for performing arrhythmia diagnosis. In addition, calculated R-R intervals from the two systems were correlated. A total number of 16 patients participated in the study. It can be considered that recorded ECG signals obtained from the wireless ECG system had an acceptable quality for arrhythmia diagnosis. Some of the patients used the wireless sensor while doing physical sport activities, and the quality of the recorded ECG signals made it possible to perform arrhythmia diagnostics even under such conditions. Consequently, this makes possible improvements in correlating arrhythmias to physical activities

PENERAPAN PENDEKATAN KOOPERATIF TIPE ROLE PLAYING UNTUK MENINGKATKAN KETERAMPILAN BERBICARA BAGI SISWA KELAS II SEKOLAH DASAR

Penelitian ini dilatarbelakangi oleh rendahnya keterampilan berbicara siswa kelas II SDN S-9. Hal ini diduga karena metode pembelajaran yang masih menggunakan metode konvensional yang terlalu didominasi oleh guru. Untuk memecahkan masalah tersebut dilaksanakan Penelitian Tindakan Kelas (PTK) dengan menerapkan pendekatan kooperatif tipe role playing. Penelitian ini bertujuan untuk mendeskripsikan tentang bagaimana penerapan pendekatan kooperatif tipe role playing untuk meningkatkan keterampilan berbicara siswa kelas II SDN S-9 yang meliputi perencanaan, pelaksanaan, dan peningkatan keterampilan berbicara siswa. Penelitian ini terdiri dari tiga siklus. Desain penelitian yang digunakan adalah Penelitian Tindakan Kelas (PTK) dengan mengadaptasi model Kemmis dan Mc. Taggart yang meliputi empat tahap penelitian yakni perencanaan, pelaksanaan, observasi, dan refleksi. Partisipan pada penelitian ini siswa kelas II SDN S-9 Kota Bandung yang berjumlah 28 siswa. Data penelitian dikumpulkan melalui teknik observasi yang bersifat kualitatif dan tes performance berbicara siswa yang bersifat kuantitatif. Pengolahan data kualitatif dilakukan dengan cara reduksi data, klasifikasi data, display data, interpretasi data, dan refleksi, sedangkan pengolahan data kuantitatif dilakukan dengan cara menghitung rata-rata nilai siswa dan menghitung presentase ketuntasan belajar siswa. Keterampilan berbicara siswa mengalami peningkatan setiap siklusnya. Peningkatan keterampilan berbicara siswa dapat dilihat dari rata-rata siklus I hanya 67,11 dengan presentase 35,71%, rata-rata siklus II meningkat 74,94 dengan presentase 75%, dan rata-rata siklus III yaitu 85,94 dengan presentase 92,85%. Berdasarkan data tersebut menunjukkan bahwa keterampilan berbicara siswa meningkat setelah menerapkan pendekatan kooperatif tipe role playing. Berdasarkan nilai rata-rata dan presentase ketuntasan keterampilan berbicara siswa maka dapat disimpulkan bahwa penerapan pendekatan kooperatif tipe role playing pada pembelajaran Bahasa Indonesia dapat meningkatkan keterampilan berbicara siswa kelas II SDN S-9 pada materi pelajaran Bahasa Indonesia. ;---This research is motivated by the lack of speaking skills second grade SDN S-9. It is characterized as a passive learning process are still using conventional methods which are dominated by the teacher. This study aims to describe how the application of role playing type of cooperative approach to improve students speaking skills class two SDN S-9 that includes planning, implementation, and improvement of students' speaking skills. The study consisted of three cycles. The design study is classroom action research (PTK) to adapt the model Kemmis and Mc. Taggart which includes four stages of research are planning, execution, observation, and reflection. Participants in this study second grade students of SDN S-9 Bandung totaling 28 students. The research data were collected through observation techniques that are qualitative and performance tests speaking students who are quantitative. Qualitative data processing is done by means of data reduction, data classification, data display, data interpretation, and reflection, whereas quantitative data processing is done by calculating the average value and calculate the percentage of students learning completeness students. Speaking skills of students has increased each cycle. Increasing students' speaking skills can be seen from the average first cycle only 67,11 with a percentage of 35,71%, the average second cycle 74,94 with a percentage of 75%, and an average of 85,94 with a third cycle is the percentage of 92,85%. Based on these data indicate that the students' speaking skills after applying the type cooperative approach increased role playing. Based on the average value and the percentage of students speaking skills mastery, it can be concluded that the application of cooperative approach to role playing in Indonesian learning can improve students speaking skills class two SDN S-9 on the subject matter Indonesian