System and methods for qualification of ECG data for remote analysis
10827941 ยท 2020-11-10
Assignee
Inventors
- David Wayne Duckert (Wauwatosa, WI, US)
- Chiranjiv Singh (Wauwatosa, WI, US)
- Brian J. Young (Wauwatosa, WI, US)
Cpc classification
A61B5/364
HUMAN NECESSITIES
International classification
Abstract
A method of obtaining and analyzing ECG data from a patient or group of patients is disclosed. The ECG data is obtained from the patient at an acquisition device. Once the ECG data is obtained, the ECG data is transmitted to an analysis server that is operated by an analysis provider and is located remote from the location of the acquisition device. Along with the ECG data, acquisition parameters are transmitted to the analysis server. At the analysis server, one of a plurality of algorithms is selected to analyze the ECG data. If an abnormality is detected, the patient information is directed to a healthcare provider who can then contact the patient to schedule an appointment. Based upon the referral, a referral fee can be transferred from the healthcare provider to the analysis provider. The patient can be prompted to provide additional information and selections that dictate the level of analysis generated.
Claims
1. A method for analyzing ECG data obtained from patients, the method comprising: obtaining ECG data and patient identification information from the patient utilizing an acquisitions device at a location; transmitting the obtained ECG data to an analysis server operated by an analysis provider and located remote from the location; obtaining a review quality selection from the patient; obtaining a response time selection from the patient; analyzing the obtained ECG data utilizing one of a plurality of processing algorithm resident on the analysis server to identify abnormalities in the obtained ECG data, wherein the ECG data is analyzed based on the obtained quality selection and response time selection from the patient; informing the patient upon a failure to detect an abnormality in the ECC data; referring the patient identification information, ECG data and identified abnormalities to a healthcare provider; and providing a referral fee to the analysis provider from the healthcare provider.
2. The method of claim 1 wherein the ECG data and the patient identification information are obtained by one of a plurality of different types of acquisition devices and transmitted to the analysis server over the internet.
3. The method of claim 2 wherein the acquisition device is provided independent of the analysis provider.
4. The method of claim 2 further comprising the step of transmitting identification information for the acquisition device with the ECG data, wherein the identification information indicates a type of the acquisition device.
5. The method of claim 4 wherein the analysis server includes the plurality of stored processing algorithm, wherein one of the plurality of stored processing algorithms is selected based on the type of acquisition device.
6. The method of claim 2 further comprising the step of transmitting acquisition parameters of the acquisition device with the ECG data.
7. The method of claim 6 wherein the analysis server includes the plurality of stored processing algorithm, wherein one of the plurality of stored processing algorithms is selected based on the acquisition parameters.
8. The method of claim 1 wherein the abnormality is arrhythmia.
9. The method of claim 1 wherein the patient identification information includes healthcare provider information for the patient.
10. The method of claim 1 further comprising the steps of: providing a web site for the healthcare provider; and creating an ECG module within the website to obtain the ECG data from the patient.
11. The method of claim 1 further comprising the step of providing a cost of service to the patient based on the review quality selection and the response time selection.
12. The method of claim 1 wherein one of the review quality selections included human over-reading.
13. The method of claim 1 further comprising the step of obtaining a analysis type selection from the patient.
14. A method for improving healthcare for patients served by a healthcare provider, the method comprising: identifying a subset of patients within a prevention class; obtaining ECG data and patient identification information from each of the patients in the subset; transmitting the obtained ECG data to an analysis server operated by an analysis provider; analyzing the obtained ECG data utilizing one of a plurality of processing algorithms resident on the analysis server to identify abnormalities in the obtained ECG data; informing the patient upon a failure to detect an abnormality in the ECC data; referring the patient identification information, ECG data and identified abnormalities to a healthcare provider for treatment upon the identification of the abnormality; calculating a cost savings for the subset of patients; and allocating a portion of the cost savings to the analysis provider.
15. The method of claim 14 wherein the ECG data is obtained from the patient at an acquisition device at a location and the analysis server is at a location remote from the location.
16. The method of claim 15 wherein the acquisition device is provided independent of the analysis provider.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) The drawings illustrate the best mode presently contemplated of carrying out the disclosure. In the drawings:
(2)
(3)
(4)
(5)
(6)
DETAILED DESCRIPTION
(7)
(8) In the embodiment shown in
(9) In other embodiments, the acquisition devices could be stand alone ECG acquisition devices that are located in public areas, such as shopping malls, office buildings, health clinics, or any other place where a patient could interact with the acquisition device 10 to obtain ECG information from the patient. As an example, a kiosk could be created that includes two metal disks on the kiosk which instructs the patient to touch the metal disks to obtain the ECG information. The kiosk-based acquisition device would contain the necessary hardware to digitize the ECG information obtained from the user and either provide a digital copy to the patient or transmit the obtained ECG data through the cloud 12. The communication between the acquisition device 10 and the cloud could be through a Wi-Fi network, direction connection to the internet, a mobile data network, a cellular network, direct connection to phone lines or any other type of communication that would allow the communication line 16 between the acquisition device 10 and the cloud 12 to exist.
(10) In addition to obtaining the ECG information at the acquisition device 10, it is contemplated that he acquisition device 10 may allow the patient to input data regarding their healthcare provider, insurance provider, and their condition or status at the time the ECG is taken. This additional information would be associated with the ECG data and transmitted over the cloud 12. As an example, the patient can input symptoms felt before and/or during the ECG recording and can input activities the user was engaged in prior to and/or during the ECG recording process.
(11) Since the ECG acquisition devices 10 are contemplated as taking multiple different forms and/or configurations, it is important for the method and system of the present disclosure to communicate various acquisition parameters that are associated with the acquisition device 10 and communicate this information with the patient specific ECG data being transmitted over the cloud 12. One method of associating the required acquisition parameters with the ECG data would be to pre-register each of the data acquisition devices 10 such that the acquisition device 10 would be associated with ECG data when the data is transmitted over the cloud. Such a registration service would allow for identification data of the acquisition device 10 to be transmitted with the ECG data from the patient such that during subsequent review and analysis at the server 18, the acquisition device parameters would be known to the analysis server 18.
(12) In accordance with a second alternate embodiment, the relevant acquisition parameters that are associated with the acquisition device 10 could be transmitted along with the ECG data. Thus, instead of requiring the acquisition device 10 to be pre-registered, the ECG data transmitted would include the specific acquisition parameters such that the acquisition parameters would be incorporated and utilized during the analysis of the patient ECG data. It is contemplated that this second, alternate embodiment would require additional data to be transmitted with each set of ECG data. However, the method would eliminate the need for pre-registration of each of the acquisition devices, which may provide additional benefits.
(13) Since a large variety of currently available and yet to be developed acquisition devices 10 are contemplated, it is important that the acquisition parameters be known during the analysis of the ECG data. As an example, ECG data that is received from the patient can be used for different clinical purposes, such as rhythm interpretation, interpretation of conduction and ischemic conditions, and interpretation of contour based features. Depending upon the clinical use of the ECG data, specific aspects and parameters of the acquisition device 10 and the resulting ECG data from the patient are relevant. Such acquisition parameters can include sample rate, frequency response, number and placement of the ECG leads, pacemaker detection, and data resolution. By either pre-registering the acquisition device 10 or by sending the acquisition parameters along with ECG data, the analysis of the ECG data from the patient can be properly analyzed.
(14) In the embodiment shown in
(15) It is contemplated that the remote analysis server would be operated and controlled by an analysis provider, which could include current companies that manufacture and provide electrocardiograph hardware. However, it is also contemplated that the analysis provider that operates and controls the remote analysis server 18 could be any other type of company or entity that develops analysis algorithms and provides the required hardware to function as the remote analysis server. It is contemplated that the remote analysis server would include the required computing processor or processors to receive ECG data from a large number of patients and analyze the data in a timely manner to return analysis information in a time frame as desired.
(16) In currently available systems in which the electrocardiograph receives information directly from the patient and the algorithms are carried out within the electrocardiograph, the data acquisition parameters are not a problem since they are known to the algorithm operating on the electrocardiograph. However, in the embodiment shown in
(17) In accordance with the embodiment shown in
(18) In accordance with another embodiment in which the acquisition parameters are transmitted along with the ECG data, the remote analysis server 18 would interpret the acquisition parameters and select and utilize the required analysis algorithm based upon the acquisition parameters. In each case, the remote analysis server 18 utilizes different algorithms based upon the acquisition parameters obtained from the acquisition device 10. In this manner, the remote analysis server 18 can tailor the analysis and selected algorithm based upon the type of acquisition device 10 utilized to obtain the ECG data from the patient 14. Such identification allows for a wide variety of different acquisition devices 10 to be utilized such that the ECG data analysis is able to be performed independent of the type of acquisition device 10.
(19) In the embodiment shown in
(20) The system and configuration shown in
(21) In step 30, the ECG acquisition device 10 obtains patient ECG data from the patient in the manner described above. As indicated above, the acquisition device 10 used to obtain information from the patient 14 can be one of a wide variety of hardware devices, such as an exercise machine, an automobile steering wheel, an electrocardiograph, a kiosk, a watch, a fitness tracker, smart phone or a wide variety of other hardware devices. This ECG data obtained from the individual patient is digitized and transmitted to the remote analysis server 18 as illustrated in step 32. The transmission of the digitized ECG data to the remote analysis server can be carried out over the cloud 12 utilizing a wide variety of communication techniques to create the communication line 16. As an example, the communication line 16 between the acquisition device 10 and the cloud 12 may be a cell phone communicating over either a cellular data network or utilizing Wi-Fi. In addition, the ECG acquisition device 10 could communicate directly to the remote analysis server 18 over to the cloud utilizing communication controlled by the acquisition device 10. In one contemplated embodiment, a kiosk in a mall could include two metal disks that allow the patient to place their hands on the metal disks such that the kiosk would obtain the required ECG data. Once the data is obtained, the kiosk that forms the acquisition device 10 would utilize required hardware at the kiosk lever to digitize the ECG data and send the digitized ECG data over the cloud 12.
(22) It is contemplated that the ECG data transmitted by the data acquisition device over the cloud may or may not include patient data. If the results from the remote analysis server 18 are going to be presented to the patient immediately at the acquisition device, patient identification information may not needed. Instead, the patient may only need to provide relevant information such as age, height, weight, and other parameters that may be utilized in carrying out the analysis utilizing the algorithms present at the remote analysis servers. However, in embodiments in which the information obtained from the patient is used in further analysis, patient identification information will be obtained. This patient identification information may include unique identifiers to the patient, such as a social security number, cell phone number, health insurance account number, healthcare provider information, or any other information that can be utilized in subsequent processing to inform the patient of the analysis results.
(23) Referring back to
(24) In step 36, if no abnormalities are detected, such positive analysis is transmitted back to the acquisition device 10 from the remote analysis server. This information could be presented immediately to the patient as illustrated in step 38. Alternatively, if the processing carried out the remote analysis server 18 will take more time than is available for the patient to remain at the acquisition device 10, the patient 14 may be prompted to provide contact information, such as a cell phone number. If the ECG is determined to be normal in step 36, the patient would be notified as soon as possible that the ECG analysis returned a normal analysis result. In the embodiment shown in
(25) If abnormalities are detected in the ECG data in step 36, the method moves to step 40 in which the patient is informed of the possible presence of an arrhythmia or abnormality in the ECG data. The patient can be notified in the same manner as in step 38, namely either at the acquisition device 10 or through a cell phone or computer address provided by the patient during the initial acquisition phase. In step 40, the method also obtains healthcare provider information from the patient. As indicated above, the healthcare provider information could be obtained when the patient initially begins the ECG acquisition process. Alternatively, if an abnormality or irregularity is identified, the method could contact the patient utilizing either the email address or cell phone.
(26) The healthcare provider information obtained from the patient in step 40 identifies the current healthcare provider for the patient. This may be a clinic, hospital, healthcare group, or any other type of healthcare provider information that is available from the patient. The patient may be also asked to provide insurance information, which would be used to select a healthcare provider if the patient does not have a current healthcare provider and would need assistance in selecting a healthcare provider.
(27) Once the healthcare information is obtained from the patient in step 40, the method moves to step 42 in which the remote analysis server operated by the analysis provider makes a direct referral of the patient to a healthcare provider network, insurer, or a specific physician. The referral generated by the analysis provider is based directly upon the identification of an abnormality in an ECG analyzed by the remote analysis server. The referral generated in step 42 would include as much information about the patient as is available, including patient identification information, the raw ECG data obtained from the patient, and an automated arrhythmia analysis report that is created by the remote analysis server 18. This information would be the information necessary for the healthcare provider to obtain initial information about the patient and would allow the provider to contact the patient directly in step 44 to set up an appointment, which would generate additional fees for the healthcare provider. The referral from the analysis provider operating the remote analysis server 18 will generate additional revenue for the healthcare provider, insurer, or physician utilizing the referral in step 44.
(28) As can be understood in
(29) In the method shown in
(30)
(31) Once the patient visits the provider website and uploads the ECG data in step 64, the ECG data is transmitted to the remote analysis server as illustrated in step 66. As discussed above in the description of
(32)
(33) In step 96, the remote analysis server 18 initially inquires with the patient as to the quality level of review that is desired. The quality level review may span from the basic arrhythmia analysis that can be automatically performed by the algorithms contained on the remote analysis server 18 to human over-read analysis to longitudinal analysis. Typically, the human over-read and longitudinal analysis requires a significant amount of additional attention and thus will not only increase the quality level of the determination but will also increase the total price point to the patient.
(34) When the remote analysis server initially receives the ECG data from the patient, an initial algorithm at the remote analysis server with inspect the ECG data to determine the quality level of the ECG data. This quality level will take into account the length of the ECG recording, the amount of noise present in the ECG data, the number of leads used to obtain the data and the type of acquisition device that was used to obtain the data. As discussed previously, the different types of acquisition devices can vary greatly and thus will determine the type of analysis that can be performed by the remote analysis server 18.
(35) If the patient selects a human over-read in step 96, the remote analysis server 18 then carries out the step of contacting a human clinician to over-read the analysis generated by the algorithms operating on the remote analysis server. The specific nature of the human over-read can also be selected by the patient. The different types of human over-read include an auction approach, standard human over-read, premium over-read by a noted specialist or marquee provided (e.g. Cleveland Clinic). Each of these different levels of human over-read may have a different price point associated with the analysis. All of these different options are presented to the patient and the patient is able to select between the different types of human over-read depending upon the type of analysis and cost desired by the patient.
(36) Once the patient has provided the quality selection in step 96, the method moves to step 98 in which the patient is asked to select the desired response time for the analysis. A response time can vary between minutes, hours or days. Typically, the faster the response time, the higher the price point. As an example, if the user would like a premium human over-read returned in hours, the price point may be dramatically higher than an automated algorithm analysis returned in a matter of days. Once again, step 98 allows the patient to select the response time and pay accordingly.
(37) In step 98, if a user uploads ECGs in bulk the user could specify rules for priority such that if a dangerous arrhythmia is detected, an immediate response should be generated and an immediate human over-read should be ordered. Again, this step allows the patient/user to dictate the cost of analysis by selecting the quality of the review and the response time.
(38) In step 100 the patient is able to specify the type of analysis desired, such as standing resting analysis, holter analysis, stress tests, heart rate recovery. Each type of analysis is presented at varied price points. By allowing the patient to select the type of analysis, the system again can offer the patient a variety of options at different price points.
(39) The analysis type selected by the patient in step 100 could also be carried out by the remote analysis server 18 upon receiving the uploaded patient ECG file. The remote analysis server 18 can review the uploaded ECG data and automatically suggest the appropriate type of analysis depending upon the type of acquisition device and other information related and present in the obtained ECG information.
(40) Once the user has made the selections in steps 96, 98 and 100, the method moves to step 102 and carries out the required analysis based upon the patient selections. In step 104, the method determines whether abnormalities are detected and if no abnormalities are detected, the patient is informed as shown in step 106. However, like the method discussed in
(41) Since the method in
(42) Referring now to
(43) In the method of
(44) As illustrated in
(45) Once the ECG data is obtained from the patients in step 154, the ECG data is transmitted to the remote analysis server in step 156 and analyzed in step 158 to determine whether abnormalities, such as arrhythmia are present. The steps are similar to those previously discussed in the method described in
(46) Since the patient was identified in step 154 and urged to have an ECG reading taken in step 154, if an abnormality is detected in step 160, it is a patient that would not otherwise have been tested but for the method of
(47) In the system and method shown in the drawing Figures, a patient or other type of person uploads ECG data to the cloud for analysis by the remote analysis server 18 can elect to have the ECG data de-identified such that the ECG data can become part of a larger database of ECG information from patients that can be used for research purposes. As discussed previously, the ECG data acquired by the acquisition device 10 is typically uploaded to the cloud 12 and downloaded by the remote analysis server 18 for analysis and detection of arrhythmias. If arrhythmias are detected, the patient informational and ECG data is relayed to healthcare providers such that the healthcare provider can contact the patient to schedule additional testing and possibly a patient visit.
(48) In the embodiment described in which the health website 28 is part of a large institution, such as the Mayo Clinic, Cleveland Clinic or other large healthcare provider, the large institution may be uploading a large number of ECGs on a daily basis. If each ECG undergoes a de-identification process, the ECG data could be stored and analyzed for research purposes. In the case of a large healthcare institution, the patient identification information can be encrypted such that only when the encryption key is present would the patient's identification information be available. In this manner, the ECG data from a large number of patients can be analyzed for research purposes while the patient information can be retrieved utilizing the encryption key.
(49) In embodiments in which this information is de-identified, a copy of the ECG records could be provided to a database at the remote analysis server 18 without any patient information. This information could then be accessed by other healthcare providers, research institutions or other interested parties without the fear of any patient identification.
(50) As the healthcare provider continues to treat the patient, the de-identified ECG data could be linked with de-identified EMR data, which includes treatment information and outcome data. This additional information would have value and could be sold to drug companies and researchers. In each case, both the ECG data and EMR data would be de-identified to prevent any patient information from being shared with the entities accessing the data.
(51) This written description uses examples to disclose the invention, including the best mode, and also to enable any person skilled in the art to make and use the invention. The patentable scope of the invention is defined by the claims, and may include other examples that occur to those skilled in the art. Such other examples are intended to be within the scope of the claims if they have structural elements that do not differ from the literal language of the claims, or if they include equivalent structural elements with insubstantial differences from the literal languages of the claims.