為恭醫院 20070913

2006

Kang-Ping Lin

Dept. of Electrical EngineeringChung-Yuan Christian University

Handheld ECG A new step in Home care

2006

Background on health management

FACTS:

• High “medicare” cost and lower government coverage are the major trend now.

• Ageing population in advanced economies show more occurrence of death threatening diseases such as cardiovascular diseases (CVDs).

• Current health care system is complex, costly, inconvenient, passive (not active and not easy in implementing preventive medicine)

• The need for a new model of high quality health care system that is simple, remote monitoring capability, self-manageable and affordable.

2006

Current Status - Taiwan

• Currently, government, research institutes and private organizations are supporting projects that are developing innovative

- Simple Home Use Medical Devices

- Remote Health Service System

- New Wellness Service Model

• The above projects leverage on the advanced IT, electronic and medical management experiences in Taiwan

• Creating a successful health & service model for implementation locally and internationally

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Importance of Monitoring Heart Function

Problems:

Cardiovascular diseases (CVDs) is the second leading cause of death in the world, right behind cancer.

There is no simple way to monitor heart function (ECG) easily except in hospital because traditional ECG require technicians to perform while Holters and event recorders are an inconvenience.

They are only recording for a short term. It is difficult for users to monitor their ECG for a long term because there is no home use ECG tool available.

Demands:

1) New device and tool to monitor ECG easily

2) Server System to collect data for long term wellness management

3) A more convenient medium for users and physicians to manage health condition

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Need

- Currently, blood pressure monitor, glucose meter, pulse oximeter are readily available by home users. However, the most important information of heart function lacked is electrocardiogram (ECG)

- The purpose of this project is to

1. Develop a medical device for users to record their ECG data easily, anywhere, anytime

2. Implement a workable health service model in the monitoring of heart function

3. Market of this new ECG device and model to health care providers

4. Implement active preventive medicine focusing on heart function and CVDs

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Purpose

Create a new health and wellness management system

- Focusing on Heart Function (Handheld ECG)

Health Care provider Ageing Society

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Before: ~100 years agoNow:Hospital Grade ECG

Handheld ECG recorder

•High Tech•Hospital Quality•Home-Hospital Linkage

Home Care Medical Devices

With 3H

Now:HomeUse ECG

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Features of Handheld ECG

Handheld ECG and its Operation

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Data Storage and ECG review software

Questions to ask user1. Do you have regular heart beat? Good rhythm?2. Do you have the right waveforms?

Features:1) Self record and storage of heart function 2) Health and wellness management of cardiac activities 3) Data to be provided to physicians as important reference


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1) Easily operated

2) Measure anytime and anywhere

3) Event recording and data storage

4) Health and wellness management

5) Telemedicine capability

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Correlation between handheld ECG & GE MAC-5000

Heart rate QRS intervalCC=0.99 CC=0.98

Clinical Study I: Measurement accuracy (1)

Correlation between handheld ECG & GE MAC-5000

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Clinical Study I: Measurement accuracy (2)

Correlation between handheld ECG & Marquette CASE-8000

Heart rate ST segmentCC=0.99 CC=0.97

Correlation between handheld ECG & Marquette CASE-8000

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Clinical Study II: Focus on Transmission

Purpose: Cardiovascular Wellness Management To verify the tele-transmission function of handheld ECG

1. Trial Location: Hospital-A Cardiovascular Department, VIP Center

2. Device & System Provider: Handheld ECG and database system. ReadMyHeart V2.0 Mini-HCC Software

Material and Methods :

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Record ECG Data Tele-Transmission Health Service

Interpretation

3. Operation Step:


via internet or Modem


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Result:

Trail Period 2006/08/01 ~ 2006/12/31

Subjects 112 Male(49) Female(63)

19 from VIP center,

37 from outpatient clinic,

56 of normal volunteer

Average age 47.7y (range: 6 ~79)

Trans. number 5376 times (48 times per subject)

Trans. success rate ~96%

Subjects Information:

Clinical Study I: Focus on Transmission

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(1) Normal,

(2) Abnormal ,

(3) Noise (defined as the waveform noise, meaning not interpretable)

Classified:

Subject number

Normal (%)

Abnormal (%)

Noise (%)

Trans.

Number

M： F Age

(range)

VIP Center

19 36

(35.3%)

48

(47.1%)

18

(17.6%)

102 13： 6 55.7

(30-79)

OPD 37 735

(57.2%)

312

(24.3%)

235

(18.5%)

1282 25： 12 44.3

(29-68)

Volunteer56 2945

(78.1%)

404

(10.9%)

418

(10.9%)

3767 25： 31 41

(6-79)

Total 112 3716

(72.3%)

764

(14.8%)

671

(12.9%)5151 63： 49 47.7

(6-79)

Result: The group of subjects and category of transmission results


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Purpose: Cardiovascular Wellness Management To record ECG data for screening in clinics

1. Trail Place: Hospital-B Division of Cardiovascular Medicine

2. Device provider: Handheld ECG (InstantCheck V4.0)


Clinical Study III: Clinical Screening

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Record ECG Data Interpretation

3. Operation Step:



Record 3 sets forLead I and Lead II Data

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Result:

Trail Period 2007/03/01 ~ 2007/6/30

Subjects 171 Male(119) Female(52)

Average age 64.4y (range: 33 ~87)

Subjects Information:

Clinical Study III: Clinical Application

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Cardiovascular Disease Diabetes CAD+DIA First

visitCategory

Normal 84 23 12 6

Deep Q 1 0 0 0

Arrhythmia 44 13 11 5

Inverse T-wave 3 1 1 2

ST-Segment Elevation 2 0 0 0

ST segment depression 4 0 0 0

ST segment depression, Inverse T-wave

1 0 0 0

Arrhythmia, Inverse T-wave 1 0 0 0

Abnormal waveform 4 2 0 0

Noise 6 1 1 0

Total Subjects 150 40 25 13


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ITRI Wellness Center Home & Office

Health Prevention

for high-tech workaholics

Background of ITRI: The largest industrial research institute in Taiwan with around 6,000 employees.

• New model for employee benefits

• Create brand new business opportunities in health prevention

• Wellness management of vital signals for company VIP

• Build awareness in daily health monitoring

Telemonitoring and e-Health Service

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• Responding to ITRI Health Management Plan:

EKG Health CareEKG Health Care

Telemonitoring and e-Health Service

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Handheld ECG and its Applications

Case A Case B

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Case A Case B

Normal subject Workaholic

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Applications: Telemonitoring

JMS, Japan :

Many private health service providers only offers blood pressure, glucose meter, weight, etc as they are widely available in the market.

Accurate, portable, easy to use personal ECG recorder is required to upgrade their current service system.

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Applications :

For Doctor

Arrhythmia Control

Drug evaluation

For User

Off-hospital monitoring

Screening

Health Management

Health Prevention

Prevention and Wellness Management

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Conclusion

1. DEVICE: A handheld ECG device is developed successfully for that allows recording of ECG data by any user without the help of professional technicians

2. SYSTEM: A workable remote monitoring of heart function is achieved through the portable ECG device and IT management structure

3. BUSINESS: Many health care providers have now implemented ECG into their system. Their business scope has increased significantly due to the additional data. It allows physicians have the most critical data on heart and thus tighten the bond between physician-patient relationship.

4. PREVENTIVE MEDICINE: With the availability of handheld ECG to complete the monitoring system, health care providers and physicians can more effectively execute preventive medicine on heart problems.

2006

Thank you &Have a good day!

為恭醫院 20070913

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