The ECG Management system shall support the IHE Retrieve ECG ...

notownbuffAI and Robotics

Nov 17, 2013 (3 years and 6 months ago)

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1


The ECG Management system shall support the IHE Retrieve ECG for Display
Profile as the Information Source
Actor.

See:


http://www.ihe.net/Cardiology/committees/upload/IHE%20Cardiology%20ECG%
20white%20paper%20March%202006%20v.6.pdf


Integrating the Healthcare Enterprise (“IHE”) is commonly known for its authorities
on and activities with digital imaging communications, i.e.
, DICOM data
management. In its white paper, “Retrieve ECG for Display Integration Profile,” the
IHE sets out the specifications vendors should meet on any ECG Management
request for proposal
(“RFP”). Like all IHE profiles, the ECG Display Profile focuse
s
on
improving patient care and improving efficiencies in the hospital/clinical
environment.


IHE specifications for ECG Management systems include:




ECG Management shall be a simple program available on every PC inside and
outside the hospital environme
nt without special client software or
workstations.



ECG Management shall use existing web standards for user accessibility.



ECG Management shall import data from ECG, stress, Holter, and other
diagnostic studies; it shall allow multi
-
vendor imports to:



Re
duce switching costs;



Allow end users to select the clinically superior product; and



End the restrictions of a single
-
vendor solution.



ECG Management shall provide the ECG data in diagnostic displays,
preferring fixed aspect ratios like a PDF, and shall pr
ovide serial comparisons
of previous ECGs.



ECG Management shall eliminate delays in diagnosis and treatment caused
by the ECG paper chase.



ECG Management shall communicate with the hospital’s electronic health
record and imaging systems.



ECG Management sha
ll integrate the hospital ECGs with the office ECGs while
maintaining perfect security and site segregation.


Patient Care

Access.




Rev 3


2
-
11
-
2013



2

ECG M
anagement shall be a simple program available on every PC inside and
outside the hospital environment without special
client software or workstations.


ECG Management shall allow full ECG viewing on a smart phone, including the Apple
iPhone and Droid without any special downloads or subscriptions.


Must allow access to the database

for up to 250 concurrent users.


Efficie
ncies

Standards.



ECG Management shall use existing web standards for user accessibility.


Must be web
-
enabled, using thin client architecture, enabling users to log on to the
system from
any

personal computer with high
-
speed internet access.


Must provi
de standard internet access that allows physicians to view, edit, and
confirm ECG records.


Must support Microsoft’s Active Directory.


Must provide support for the application by remote
-
system access.


Must run as an application on locally purchased hardw
are
/VMware

i
n the user’s
domain.


Must provide the ability to mirror databases.


Patient Care

Multi
-
Modality/Multi
-
Vendor.


ECG Management shall import data from ECG, stress, Holter, and other diagnostic
studies; it shall allow multi
-
vendor imports to:

Reduce switching costs;

Allow end users to select the clinically superior product; and

End the restrictions of a single
-
vendor solution.


Vendor shall list all compatible devices in the following modalities:


Resting electrocardiography

Stress testing

Hol
ter monitoring

Bedside and telemetry monitoring

Event monitoring



Rev 3


2
-
11
-
2013



3

Mobile Outpatient Cardiac Telemetry

Pacemaker follow
-
up

Ambulatory blood pressure monitoring

Pulmonary function testing

Cardiac rehabilitation

EEG


Sleep

Defibrillators

T
-
Wave Alternans


System shall
also acce
pt PDF/scanned images from any source
, including third
-
party scanning services,

with the following workflow requirements:


Create

a new modality in the database;

Populate

all demographics with an ADT or orders feed;

Provide

a cover pa
ge for physician interpretation;

Support

forms (user
-
customized text inserts);

Confirm

with electronic signature;

Post

HL7 messages into the EMR; and

Analyze

with administrative reporting.




Patient Care

Diagnostic Quality.


ECG Management shall provide
the ECG data in diagnostic displays, preferring fixed
aspect ratios like a PDF, and shall provide serial comparisons of previous ECGs.


Must be able to migrate resting ECGs from the legacy ECG management system.


Must perform serial comparison using edited

and confirmed interpretations from
previous ECGs.


Must provide rhythm and interval calipers where the interval calipers are used to
march P waves and the interval calipers measure RR, PR, QT, QRSd.


Amplitude calipers must also measure ST segments.


QT c
orrection formulae must include user selectable Bazette, Fridericia, Linear, and
Exponential algorithms.


QT correction must give users the ability to select a single RR interval to use as the
heart rate value for QTc.




Rev 3


2
-
11
-
2013



4

Must simultaneously display a previo
us ECG with the current ECG.


Must utilize custom editing tools, i
ncluding typed data entry, drop
-
down
interpretive phrases, customized macros, and support for third
-
party voice
recognition software.


Efficiencies

Time Saving.

ECG Management shall elimina
te delays in diagnosis and
treatment caused by the ECG paper chase.


Must print previous ECGs from every PC and printer in the hospital.


Must generate management reports, e.g., number of unconfirmed ECGs passed 24
hours, number of ECGs per physician per
month; number of ECGs per technician per
day, etc.


Must support ad
-
hoc queries and management reports from those ad
-
hoc queries.


Must support

user
-
customized text inserts
/forms.


Efficiencies

Automatic charting
. ECG Management shall communicate with the

hospital’s electronic health record and imaging systems.


Must be able to interface with XYZ EMR


Must be able to take orders from XYZ EMR


Must be able to post results back to XYZ EMR wi
th alpha
-
numerics and waveforms


M
ust either transfer

waveforms

to X
YZ EMR as PDF files or provide
a
URL lookup
inside the ECG Management system.


Must send “complete” messages to XYZ EMR’s billing software.


Shall support ADT from XYZ EMR.


Must support Web API access to the entire study in the ECG Management system.


Patient Care

Full Records
. ECG Management shall integrate the hospital ECGs with
the office ECGs while maintaining perfect security and site segregation.


Must support ECG inputs from multiple sites.




Rev 3


2
-
11
-
2013



5

Must allow the

restriction of Orders, Administrative R
eports, and Work lists, by site.


Must securely segregate the ECG data from the multiple sites.


Must allow creation of different users with different privileges, i.e., referring
physicians with view and print privileges, technicians with edit but not
confirm
privileges, reading physicians with edit and confirm privileges, and administrators
with plenary privileges.


Must maintain a complete log of each user’s interaction with any patient’s record.


Must maintain a history of the interpretative changes
on any