Voice supports a variety of telephony equipment, including TAPI-compliant hardware, multiline voice-response boards, and single-line fax/modem/voice boards. The developers used assembly language to code the portion of the system that does real-time collection of the ECG data.
"Visual Voice gave us a simple yet powerful toolkit to leverage our expertise in Access Basic and develop quickly," according to Dr. Michael Bergelson, CardioVoice's chief designer.
CardioVoice has two major components: proprietary CardioVoice Phone clients and an unattended "receiving station" telephony server, which is normally located in the physician's office. The proprietary CardioVoice phones (desktop, portable, or cellular) are actually pac
emaker and ECG transmitters. By attaching special electrodes to the phone handset and either holding them with both hands or pressing them to their bare chest, patients can easily transmit frequency-modulated heartbeat data to a receiving station. The receiving station converts the analog data to digital form and transmits the patient's name, phone number, and heart rate to the attending physician's alphanumeric pager. The physician can then dial into the receiving station and have the patient's ECG plot faxed back to them.
The basic Paceart system runs on a Windows PC. Receiving stations are typically a Pentium-class PC with 16 MB of RAM running Windows 95. The Dialogic Proline/2V telephony card that's used in the system can handle two analog lines simultaneously. The 16-bit Dialogic cards support such features as caller ID, global dial-pulse detection (optional), TAPI, and WAV audio.
The setup generally uses only one or two lines. This allows the developers to deploy the system on an inexpensive Win
dows 3.11 or Windows 95 PC. For reliability, the designers use redundant phone lines and often connect two telephony servers that work in tandem to minimize downtime if the PC or telephony card fails.
Currently, more than 450 pacemaker and arrhythmia centers are using the Paceart system to monitor about 75,000 patients every day. The system's primary users are people who wear pacemakers and others who are considered at-risk and require intermittent cardiac monitoring. Each patient has a unique voice-mail box that enables patients and physicians to communicate efficiently. CardioVoice can also make scheduled calls to subsets of the patient database to confirm appointments, send medication reminders, and relay test results.
Dr. Jay Erlebacher
of Cardiology Consultants is an enthusiastic user of CardioVoice primarily because it is convenient for physicians and patients. "In the past we had to rely on a service bureau to distribute the loop recorders to the patients, attend the phone
uploads of the data, and deliver the results to us. This whole process would often take several days. With CardioVoice and our own Paceart loop monitors we can be monitoring a patient and receiving results in a day or less without being at the mercy of an unresponsive and expensive service bureau."
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Visual Voice helped build a CTI application that frees cardiologists from "unresponsive service bureaus."
Joe Tartaglia is the vice president of High Caliber Systems (New York City), a developer of custom computer telephony systems. You can reach him at
JoeT@HighCaliber.com
.
Visual Tools to the Rescue
