Tuesday, December 7, 2010

Meaningful Mobility for Cardiology Care

A 12-lead ECG is a snapshot in time of 3 spatial views of the heart's electrical activity from 12 angles. It is generated by placing 10 electrodes on various parts of the body including the arms, legs, and chest. With a 12-lead, we are simply taking a multi-dimensional picture of heart conduction from right to left, top to bottom, and front to back.

Once the electrodes are placed, the ECG recorder is run. The recorder digitally captures the multi-dimensional picture. Although the machine will virtually record all 10 seconds of data per lead, all traditional ECG print outs and the current pdfs currently used in most mobility solutions only provide 3 seconds of data for each lead, and those three seconds are printed, static, flat, and non-interactive.

The output of an ECG recorder is a tracing on a graph. Time is represented on the x-axis, and voltage, or amplitude is represented on the y-axis. Look at the following picture describing the time and voltage for a traditional ECG tracing. Notice, for example, how one small 1 mm x 1 mm block represents 40 milliseconds in time and 0.1 millivolts in amplitude? (See Figure 1).

Now let’s look at how mobility providers can add serious value to the ECG equation. One way is to mobilize a pdf version of the ECG tracing. (See Figure 2). Helpful - but where is our data transformation in this equation? Consider it’s time to move to the next generation mobile solution. (Figure 3).


Figure 1

Figure 2





Figure 3















AirStrip Cardiology ™ provides the ability to scroll through a full 10-second ECG for all 12 leads and set any of the leads as the rhythm strip – clinicians choose the beats used for analysis. In addition, the dynamic ECG layout functionality grants full control over how leads are rendered, providing the option to see all 12 or 15 leads for the ECG or selectively, in various comparative layouts and zoom levels.

AirStrip Cardiology can help clinicians detect changes in mV signal as low as .05 mV (0.5 mm). That’s a twentyfold increase in amplitude detection over paper tracings. End users clearly see sub-millimeter variations, as well as being able to visually scan all 12- or 15-leads at once and see any relative deviations.

In terms of playback control, marking the grid with the measurements coming from GE Marquette® 12SL™algorithms, we also allow play modes for the 10 second digital segment to be full, 1/2, 1/4, or 1/8 speed, as desired. Added features such as user-driven lead selection, maintaining relevance across leads with synchronized pinch and zoom, make this exponentially more interactive. Now that’s meaningful mobility.

References:
[1] http://en.wikipedia.org/wiki/File:ECG_Paper_v2.svg
[2] http://en.wikipedia.org/wiki/File:12leadECG.jpg
[3] © 2010. AirStrip Technologies. All rights reserved

4 comments:

  1. Dear Dr. Powell,
    I have been following your blog for sometime, as a premed student and a having a family with cardiac history, I would wonder if the airstrip solution is strictly hospital based or is there a way this could be used by patient at home.

    Bob.

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  2. Dear Bob,

    Thanks for your readership.

    Just to be clear - the consumers of the data rendered by our products today are clinicians, rather than patients. AirStrip products are designed to provide clinical decision support about patients to providers rather than to inform or educate the patient and family.

    That being said, AirStrip mobilizes waveforms and other patient data from a variety of clinical information systems. Currently, we mobilize data obtained from an interface to servers which house data for multiple patients being managed and tracked, traditionally a hospital clinical information system. It’s not the patient or provider location, it’s the ability to interface to a centralized data repository which houses the patient data, labs, meds, and EHR. If a home monitoring provider was collecting and aggregating patient data centrally, we could easily mobilize that information.

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  3. Dr. Powell,

    We are an innovative home health care agency who is looking to increase physician involvement with our cardiac patients in the home. Might we be able to integrate the AirStrip technology into our practice? I am very interested in your thoughts on this application of the product. Thank you!

    Matt Volansky, PT, MBA, OCS, ACHCE
    Cleveland, OH

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  4. This could be some amazing technology, a Brooklyn cardiologist was just telling me the other day how he thinks this could be the next big thing in medicine

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