Introduction

touchECG is a digital resting ECG acquisition & management solution designed by Cardioline. The Windows based application facilitates the collection of diagnostic 12/15-lead ECGs.

An integration with ClinSpark and the ClinSpark Agent was designed based on touchECG version 3.51.13057.2.

Pre-requisites

1. Cardioline touchECG compatibility was added with ClinSpark Agent version 1.4. However, we recommend using Agent version 23.1 or above (https://foundryhealth.atlassian.net/wiki/spaces/DOCS/pages/3700490299/ClinSpark+Agent?src=search).

2. Cardioline touchECG software must be installed in the PC ‘LocalAppData’ directory (example: <User>\AppData\Local\Cardioline\touchECG )

Overview

A quick walk-through video showing the basic configuration and use of touchECG.

Advanced Use Cases

Demo Mode

Cardioline has designed touchECG with the ability to run in Demo mode, and thus it allows for working with simulated ECGs built into the application rather than requiring actual hardware or applying leads / procuring a simulator. Information about this can be reviewed in their service manual.

ClinSpark allows for Demo Mode to be set proactively for each invocation through global device configuration (via Devices > Configure). When set, the interface will have the user.config XML file contain the HDPLUS_SN in each invocation to be hardcoded to 'DEMO'.

Here is the setting:

Preventing ECG data being stored on a local or shared drive

This technical walkthrough view shows the configuration required to prevent ECG data being stored on local directories - the data is ingested into ClinSpark only.

File Formats

1. Cardioline touchECG creates both PDF and ‘SCP’ (data) files that are consumed by ClinSpark.

Data Workflow

• Invoke device; Agent receives digitally signed JSON timepoint payload from the ClinSpark server

  • Timepoint contains a unique 'item group data id'

• Agent attempts to locate the touchECG EXE; EXE path is built using 'LocalAppData' environment variable and appends Cardioline/touchECG/touchecg.exe

  •   If EXE is not found, user is given a warning message and test ends

• Agent attempts to find working results dir; path is built using 'AppData' environment variable and appends Local/touchECG/clinspark to it

• Agent ensures an archive directory is present as a subdirectory of results using date timestamp and host name information

• Agent creates an order text file that contains ID (randomization, lead-in, screening number), FIRSTNAME (mapped to study event and nominal timepoint), LASTNAME (study name), SEX (1=male, 2=female), BIRTHDATE (formatted yyyyMMdd), ACESSIONNUMBER (mapped to item group data id described above)

• Agent creates user config XML file applying logic to configure the powerline filter, SCP path, PDF path, database path (directory where text and user config files are written)

• When user order text and user config files are written, the touchECG executable is invoked in a separate thread, and it is passed as command line arguments -g -d <order file path>, -c <user config path>

• The Agent then presents a modal to the user in ClinSpark that the order has been created, and it instructs the user to complete the test and press 'ok' when touchECG is closed.

  • The test is completed in touchECG software; users will end the workflow and return back to ClinSpark.

• When the user presses 'ok' on the modal in ClinSpark, the Agent then begins the process to look for the result files; the result files must be named with the item group data id and be immediately followed with a suffix

• If the files are not found in a given poll cycle, the Agent will attempt to look again; if it is determined that the EXE is no longer active and 8 seconds have elapsed, the Agent will give up polling and return an error message to the user

• When the files are found, the SCP file is parsed and the intervals and interpretations are returned to the browser as JSON, and then the respective fields are set in the browser using JavaScript; the original SCP file is also saved with the ClinSpark form in the browser.

Manufacturer's Reference Material

https://cardioline.com/

Watch on YouTube

Service Manual

A copy of the touchECG version 3 service manual is embedded here for your convenience…

Additional Reference Material

1. SCP-ECG V3.0: An enhanced standard communication protocol for computer-assisted electrocardiography

   1. https://ieeexplore.ieee.org/document/7868741

2. Standard Communications Protocol for Computer-Assisted Electrocardiography

   1. https://www.iso.org/standard/46493.html