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Msc Thesis Template Document EXTENDING THE SANA MOBILE HEALTHCARE PLATFORM WITH FEATURES PROVIDING ECG ANALYSIS by KATERINA TSAMPI Bachelor Degree in Computer Science and Information Technology of the Technological Educational Institute of West Macedonia in Kastoria, 2012 A THESIS submitted in partial fulfillment of the requirements for the degree MASTER OF SCIENCE DEPARTMENT OF INFORMATICS ENGINEERING SCHOOL OF APPLIED TECHNOLOGY TECHNOLOGICAL EDUCATIONAL INSTITUTE OF CRETE 2017 Approved by: Assistant Professor Spyros Panagiotakis Copyright © 2017 KATERINA TSAMPI 2017 All rights reserved. No part of this material may be reproduced, displayed, modified or distributed without prior written permission from the author or author’s institute – except in the cases of noncommercial research and nonprofit education, which has to be accompanied by the appropriate citation. 2 Tsampi Katerina Abstract The great development of technology recently provides innovations that improve everyday life. The major benefit is that the branch of medicine is also affected, so better healthcare can be provided. In that context, it can be critical for patients who suffer from chronic heart diseases to have in their availability a system that can monitor and analyze their electrocardiogram (ECG) displaying either normal or abnormal findings. The current thesis implements such a system that uploads, stores, processes and displays an ECG, calculating certain ECG findings necessary for doctors to make a diagnosis. To this end, the SANA mobile healthcare platform, with its OpenMRS open source enterprise electronic medical record system, has been chosen and extended for storing, processing and displaying the ECG data. OpenMRS provides a user-friendly interface and a database for collecting medical big data. Analysis of ECG signals is leveraged by the Physionet toolkit. Physionet contains many ECG databases and the WFDB software for processing ECG signals. According to the scenario we have processed, an ECG is uploaded onto OpenMRS platform using a mobile device or any other Internet- enabled device and is stored in the database that OpenMRS uses. Then, ECG signal is filtered using a finite impulse response (FIR) filter to remove noise and using WFDB functions it is processed so certain intervals are determined. Finally, with the appropriate algorithms specific ECG findings are calculated. When the procedure completes, the results are stored into the database using SQL Queries. Using an HTML Form results and graphs are integrated into the OpenMRS website highlighting abnormal values with red color. Authorized users can have access to this information through any web browser. The implementation has been evaluated with various demo ECG signals verifying its correct behavior. Keywords: Electrocardiogram, OpenMRS platform, WFDB software, ECG processing 3 Tsampi Katerina Table of Contents Copyright © 2017 ........................................................................................................................... 2 Abstract ........................................................................................................................................... 3 Table of Contents ............................................................................................................................ 4 List of Figures ................................................................................................................................. 6 List of Tables ................................................................................................................................ 10 Acknowledgements ....................................................................................................................... 11 Chapter 1 - Introduction ................................................................................................................ 12 Chapter 2 - Related Work on Health Care Applications ............................................................... 15 Overview ............................................................................................................................... 15 Big Data and HIT .................................................................................................................. 15 IoT-based Healthcare Applications ....................................................................................... 16 Mobile Health Care Applications ......................................................................................... 18 Electronic Medical Record Systems ......................................................................................... 21 Electrocardiogram ..................................................................................................................... 22 ECG Waves ........................................................................................................................... 23 ECG Leads ............................................................................................................................ 28 ECG Standard formats .......................................................................................................... 31 ECG Signal Filtering ............................................................................................................. 35 Chapter 3 - Physionet .................................................................................................................... 37 PhysioBank ............................................................................................................................... 37 PhysioToolkit ............................................................................................................................ 38 Chapter 4 - OpenMRS – Sana ....................................................................................................... 42 History of OpenMRS - Sana ..................................................................................................... 42 Technical Specifications of OpenMRS ................................................................................. 43 Architecture of OpenMRS ........................................................................................................ 44 OpenMRS Data Model ......................................................................................................... 46 Definitions ................................................................................................................................ 48 Scenario Analysis ..................................................................................................................... 53 User Interface ............................................................................................................................ 54 4 Tsampi Katerina Patient Dashboard ................................................................................................................. 58 Access Control .......................................................................................................................... 61 Management of Concepts ........................................................................................................ 62 Chapter 5 - Technical Implementation ......................................................................................... 65 System Design .......................................................................................................................... 65 ECG Findings ........................................................................................................................ 70 Uploading ECG file .................................................................................................................. 75 ECG Signal Processing ............................................................................................................. 79 Using WFDB applications .................................................................................................... 79 Processing Algorithms .......................................................................................................... 87 Connection to Database ........................................................................................................ 98 Display Results ....................................................................................................................... 100 Chapter 6 - Experimental Evaluation .......................................................................................... 107 6.1 Myocardial Infarction ....................................................................................................... 107 Results ................................................................................................................................. 113 6.2 Myocardial Hypertrophy ................................................................................................... 116 Results ................................................................................................................................. 122 6.3 Cardiomyopathy Heart Failure ......................................................................................... 125 Results ................................................................................................................................. 131 Chapter 7 - Conclusion and Future Work ................................................................................... 134 References ..................................................................................................................................
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