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16 March 2020 Automatic alerting of accidents and emergencies: the international standard accident number and vital sign data embedded in future PACS
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Digital Imaging and Communications in Medicine (DICOM)-based picture archiving and communication systems (PACS) primarily collect data that health-care professionals acquire in hospitals for diagnostics or therapeutics, but integration of data from continuous health monitoring is not yet included. Smart wearables or smart clothes, but also smart environments such as apartments, homes, or vehicles collect such data. While cars already generate automatic alerts, for example the eCall system in Europe, smart homes or smart wearables will generate such alerts in near future, too. However, the response to automatic alerts still is operator-based. There is no technical link between the information technology (IT) systems operated by the rescue service, the emergency departments, and the hospitals. We suggest an international standard accident number (ISAN) that is created by the alerting system and supports communication between the systems of the rescue chain and secure data sharing. In this paper, we draw a scenario in which we enhance smart vehicles and smart homes with health-related unobtrusive sensing devices for vital signs and capture environmental, behavioral, and physiological parameters simultaneously from the shell-like private environment that cars and homes provide the humans. Via the ISAN, the data is communicated safely and securely to the hospital. We further analyze recent DICOM extensions on suitability to capture such data in the PACS of the hospital. The Vital Sign Template (TID 3510) extends DICOM Structured Reporting but captures such measures only at a particular point of time, rater than continuously. DICOM Waveform Data (DICOM 3.0 Supplement 30, added in 2000) was designed particularly for ECG data. It can store continuous recording of up to five sequence items of up to 13 channels. However, it does not cope with any information describing the capturing device, position, or other semantic information. In conclusion, vital sign monitoring cannot sufficiently handled with DICOM and its extensions of today.
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Ramon Barakat and Thomas M. Deserno "Automatic alerting of accidents and emergencies: the international standard accident number and vital sign data embedded in future PACS", Proc. SPIE 11318, Medical Imaging 2020: Imaging Informatics for Healthcare, Research, and Applications, 113180X (16 March 2020);

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