Interoperable Integration of Automatic ECG Processing Using DICOMweb and the AcuWave Software Suite

Established cardiovascular risk scores are typically based on items from structured clinical data such as age, sex, or smoking status. Cardiovascular risk is also assessed from physiological measurements such as electrocardiography (ECG). Although ECGs are standard diagnostic tools in clinical care, they are scarcely integrated into clinical information systems. To overcome this roadblock, we propose the integration of an automatic workflow for ECG processing using the DICOMweb interface to transfer ECGs in a standardised way. We implemented the workflow using non-commercial software and tested it with about 150,000 resting ECGs acquired in a maximum-care hospital. We employed Orthanc as DICOM server and AcuWave as signal processing application and implemented a fully-automated workflow which reads the ECG data and computes heart rate-related parameters. The workflow is evaluated on off-the-shelf hardware and results in an average run time of approximately 40 ms for processing a single ECG.