Research on Establishment of Supporting System for In-Home Cardiovascular Medicine

本研究的目的是通过互联网将12导联心电图从患者家中传输给心脏病专家，并将其即时报告给患者，以建立心血管疾病家庭医疗支持系统。在日本，最近更喜欢家庭医疗而不是医院护理的患者数量正在增加。然而，在接受家庭医疗护理的患者中，没有定期记录心电图。由于居家医疗的患者年龄较大，且经常患有缺血性心脏病等心血管疾病，因此建立居家护理的心电记录和报告系统显得尤为重要。起初，我们找不到日本制造的可以上网的移动12导联心电系统。我们通过小灵通发现了美国制造的300g的移动12导联心电系统，可以上网。我们建立了如下心电记录和报告系统：1.护士携带300g移动式12导联心电系统和移动式p…更多的个人电脑(PC)与她一起在家中护理。2.护士在医生的指导下记录12导联心电图。3.记录的12导联心电信号从家庭护理现场通过互联网发送到心脏病专家的PC上。心脏病专家在办公室的PC或办公室外的移动PC收到12导联心电报告后，立即用便携电话发送报告。这些项目得到了名古屋大学医学院伦理委员会的批准。通常情况下，心脏病专家的报告可以在护士完成家庭护理前10分钟内到达护士手中，她可以当场向患者简要解释心脏病专家的报告。数据使用Password存储，此外，如果没有特殊软件，则无法查看数据。发送和报告了超过35个心电图示。对几位患者进行了随访的心电记录。在这些患者中，部分心电图显示ST-T改变和心律失常，为家庭医疗和家庭护理提供了有用的信息。较少

The purpose of this research was to establish the support system for in-home medical care of cardiovascular disease using transmission of 12-lead electrocardiograms (ECGs) by internet from patients' home to cardiologist with immediate report of ECGs to patients. In Japan, the number of patients who prefer in-home medical care to hospital care is increasing recently. However, ECGs are not recorded regularly in patients under in-home medical care. It seems to be important to establish ECG recording and reporting system for in-home patient care because patients under in-home medical care are aged and frequently suffering from cardiovascular disease such as ischemic heart disease. At first, we could not find mobile 12-lead ECG system made in Japan with internet accessibility. We found US-made mobile 12-lead ECG system of 300 g with internet accessibility by PHS. We established ECG record and reporting system as followings ; 1. A nurse carries mobile 12-lead ECG system of 300 g and mobile p … More ersonal computer (PC) with her in home nursing. 2. A nurse records 12-lead ECGs under the direction of a doctor. 3. Recorded 12-lead ECGs are sent from the site of home nursing to cardiologist's PC through internet. A cardiologist send report of 12-lead ECGs by portable phone immediately after receiving them by PC at office or mobile PC out of the office. These programs were approved by the ethical committee of Nagoya University School of Medicine. Usually a report from a cardiologist could be reached to the nurse within 10 min before she finished home nursing, and she could explain the report from a cardiologist briefly to the patient on the spot. Data were stored with Pass Word and, in addition, data cannot be viewed without special software. More than 35 ECGs were transmitted and reported. Follow up ECG recordings were performed in several patients. In those patients, some ECGs showed ST-T changes and arrhythmias, and provided useful information for in-home medical care and home nursing. Less