Computer Applications in Medical Care. Ambulatory Care Computer Systems. Implantable Devices: Cardiac Pacemakers: Designing a Computer-Assisted Clinic to Cope with the Evolution of Pacemaker Technology

摘要

A computer-assisted program for follow-up monitoring of implanted cardiac pacemakers has been in operation at the San Francisco Veterans Administration Medical Center since 1977. It was originally created at a time when the technology of pacemakers was stable and only a few parameters could be measured or telemetered. Two recent developments have necessitated a major reassessment of this project as a well as redesign of the entire computer infrastructure: the advent of multi-programmable and multi-chamber pacemakers (presenting a wide variety of selectable and interacting parameters and features) and the expansion of the program to follow 4000 patients. In addressing the above two problems we have embarked on a project which involves distributed data structures, interactive multi-tasking and non-deterministic data structures. The resultant computer-based system will allow for maximum flexibility in the definition of data for differing pacemakers while permitting coherent and meaningful studies to be performed across large patient populations.