HealthExpress system Innovative screening without complication

In the complexity of modern medicine, diagnosis and technology there is an increasing challenge to professionals to engage with patients that enable effective screening and lifestyle changes before clinical intervention

Manufacturer:Medical Computer Systems

Zelenograd, Moscow, 124460 Russiawww.mks.ru, mks@mks.ru

tel.: +7 495 913 31 94

The HEALTH EXPRESS HSS is used in the system of preventative and school medicine in all Russian regions, with over 28 million patients undergone the screening examination with application of this system.

Registered as the medical device in the Russian Federation:

Health Express HSS - RU No.ФСР 2010/07742

Registered as the medical device in EU countries:

healthExpress - CE 574163

Registered as the medical device in the Republic of Kazakhstan:

Health Express HSS - RK-MT-5No.015012

IMPLEMENTATION

The final declaration of the First World Ministerial Conference for

Healthy Lifestyle and Noncontagious Diseases Control (Moscow 2011), WHO’s

experts noted that special focus should be placed on identification of disease at

the earliest stage, as well as the on the primary and secondary prevention by

means of thorough screening of populations to identify persons with the high

CNCD development risk factor values. The conference participants highly

evaluated the experience of the Russian Federation for organization of the

health care innovation structure - the system of Health Centers

founded in 2009-2010.

The HEALTH EXPRESS Hardware-software system (HSS) was developed

for Health Centers. The system is used by more than 1,000 adult and children

health centers, including mobile centers involving buses, small buses,

cross-country vehicles. Over 28 million Russian citizens underwent examination

at Health Centers as of the beginning of 2018.

The HEALTH EXPRESS HSS is widely applied for screening and control of

treatment at preventative treatment polyclinics, private clinics, health points,

diagnostic centers, medical offices of sports school and Sports Medicine Centers

of FMBA, in the Urgent Psychological Help Center of the Ministry for Civil

Defence, Emergencies and Disaster Response (Emergencies Ministry).

Over 1,200 educational institutions in the RF and EEU states

are equipped with various versions of HEALTH-EXPRESS HSS for school

medical offices.

The HEALTH-EXPRESS HSS are supplied to the European Union States.

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SCORE

Stress level control system (SLCS)

Spirometery Statistics

Ankle-brachial index

Health-express Acuity of vision

Luscher test

ECG-12

STRESS-TEST

AUDIT questionnaire

Hospital Anxiety and Depression Score (HADS)

Nicotine addiction level

Anthropometry

CNCD risk factor assessment

Express blood test

Smokerlyzer

HEALTH EXPRESS has been developed based on the modular concept, which

allows selecting the system’s components

taking into account specific tasks.

HEALTH-EXPRESS units are additional programs or hardware-software solutions,

connected to the patients’ data base. The data base ensures organization and

storage of data about patients and results of their examination, as well as unit

communication, on the one hand, and external medical informational systems

(MIS), on the other hand.

- Base module system

- Optional module system

SimpleReport

For non-medical personnel or self-use by patients - this report displays aggregated examination data in easy to understand visual format.

GeneralReport

Aimed at the Family Physician, Paramedical and Allied personnel - this report displays basic quantitative data, graphics and conclusions;

ExpertReport

SG

Ex For Internists and Cardiologists - this report contains all quantitative and graphical data.

HealthExpress uses two methods: HeartVUE for measuring ECG microalternations andHeart Rate Variability analysis for determination of its functional state.

Three types of report are generated automatically:

HealthExpress is a ‘simple to use’ device

utilizing 4 limb electrodes to deliver a highly effective heart health screening solution. Simple computer interpretation provides for increased patient-doctor interaction with the results delivered in just 3 minutes without the need to remove clothing. Compact and fully portable, the device requires only minimal training for ease of interpretation using the visualization.

Advanced Analysis and Interpretation

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Method 2: Heart rate variability for determination of the functional state

Heart rate variability (HRV) analysis is a standard science-based prenosological tool that

measures change in the time intervals between adjacent heartbeats and is directly related to

the body's interdependent regulatory systems. An optimal level of HRV within reflects

healthy function, an inherent self-regulatory capacity, adaptability and resilience.

To measure HRV requires a 3 or 5-minute ECG recording.  The time and frequency parameters

are recorded and the functional state is expressed as an Activity Index of Regulatory

Systems (IRSA).

Highly accurate with Sensitivity 84%

with Specificity 73% for Myocardium index.

Testing results – PTB ECG database from

National Metrology Institute of Germany.

Physiological normalThe subject is well adapted.

Prenosological stateFor maintaining the homeostasis, specific functional resources have to be mobilized and the regulatory systems are strained.

Premorbid stateUnsatisfactory adaptation.

Premorbid stateHomeostasis is disturbed. Specific pathological changes develop at functional and system level.

Method 1: HeartVUE for measuring ECG microalternations

HeartVUE selects 30 seconds segments from a 3 or 5 minutes ECG record and analyzes the

low-amplitude oscillations in ECG-signals automatically - microalternations analysis. This is a

fundamental difference from a standard ECG contour analysis. The analysis is shown

in the Myocardium index and another 9 indices,

which detail the changes in heart zones.

Microalternations are sensitive indicators

of the mechanisms of regulation of heart.

The system reacts to small metabolic changes.

IRSA 1-3

IRSA 4-5

IRSA 6-7

IRSA 8-10

IRSA steps

M Integrated index Myocardium

0% ...14% - Norm 15% ...18% - Borderline state 19% ... 23% - Significant deviation 24% ...100% - Pronounced deviation Detalling: 0-1-0-0-5-0-0-0-0

PARSE (IRSA) Activity index of regulatory systems

1 ... 3 step - Physiological norm 4 ... 5 step - Prenosological state 6 ... 7 step - Premorbid state 8 ...10 step - Failure of adaptation

IntegralMyocardium index

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Medicine department # 2

03.08.2018 15:50Date of research Pa�ent Doctor

по записи ЭКГ длительностью 3 мин

Анализ вариабельности сердечного ритма

Общее

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Basic report exampleof Health - express unit

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PARSE (IRSA) 4 deviat. Pulse rate (HR), bpm 71,7 normMxDMn, ms 195 norm SDNN, ms 36,3 normCV, % 4,3 norm Mode amplitude (AMo), % 50,2 normStress index (SI) 156,2 norm IC 5,2 normPower VLF,% 45,9 deviat. Power LF,% 38 normGeneral conclusion: 4 points: Your state is characterized by moderate voltage of regulatory systems where for adapta�on to

the environment body needs extra func�onal reserves. Such states arise in the process of adapta�on tolabor ac�vity, under emo�onal stress or effect of environmental factors.

years

on ECG record 3 min

Analysis of microaltera�ons HeartVueMiocard, % 14 norm Rhythm,% 8 normPulse, bpm 72 norm Detaliza�on L-0-0-S-0-0-0-S-0 normFunc. reserve, % 81 norm

General conclusion: No significant DISPERSIVE devia�ons.

Anthropometry unit

The unit is aimed at measuring:

• body height and weight,• arterial pressure

• wrist strength (dynamometry), • chest, shoulder and head circumference, • skin and fat folds thickness (calipometry)

Based on the measurement values:

• the bode mass index (BMI) is calculated, centile gender and age weight and height assessment is carried out• the somatotype for patients below 18 years old is determined• the trophological status for patients above 18 years old is determined• the nutrition condition interpretation is made• the body component composition is assessed• the strength index is determined

Comes with the auxiliary equipment:

PC-based scales, height meter, dynamometer,

centimeter tape, digital thermometer,

PC-based automated tonometer.

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Contact-free height determination

Height measurement without manipulations with the movable bar is carried out automatedly. Three optic units calculate the accurate height and do not react to strange objects. At the same time, the patient is weights and the Body mass index (BMI) is calculated. The results are instantly entered into the computer system. USB or wireless BLE connection is used.

Our scales with the height meter unit MKS-VEM-R-200 determine the height within the range of 100...200 cm and the body weight within the range of 20...200 kg.

89.6

182.526.9

кг

см

2кг/м

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CNCD risk factor assessment unit

The “CNCD risk factor assessment” unit is used to carry

out the poll (questionnaire survey) of citizens during

standard medical examination of adult population for

identification of chronic non-contagious diseases,

factors of risk of their development and consumption

of narcotic and psychotropic substances without

doctor’s prescription. The opinion based on the data obtained regarding the

necessity of further examination and consultations is generated automatedly.

SCORE unit

“SCORE” unit is aimed at the assessment of the

aggregate risk of cardio-vascular diseases based on the

patient’s risk factors entered into the system. The

opinion with recommendations for correction of

CNCD risk factors is generated automatedly.

Stress level control system (SLCS) unit

“SLCS” Unit is used to carry out the

psycho-physiological examination including

presentation of visual cues, assessment of the visual

and motor reaction speed and identification of the

organism’s functional preparedness.

Comes with:

FirstSync psycho-physiological

diagnostics control.

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Express blood test unit

The “Express blood test” unit helps to obtain automatedly,

assess and store the blood express examination data.

Comes with:

blood express tester

KardioCheck PA (to be purchased additionally).

Smokerlyzer unit

The “Smokerlyzer” unit carries out the

function of automated obtainment,

assessment and storage of the exhaled

air gas analysis data with determination

of the СО and

carboxyhaemoglobin level.

Comes with:

MicroCO

Spirometery unit

The “Spirometry” unit carries out the function of

automated obtainment, assessment and storage of

the spirometry data for comprehensive evaluation

of the respiratory system.

Comes with:

SpiroUSB spirometer

(to be purchased additionally).

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Ankle-brachial index unit

The “Ankle-brachial index” Unit is used to measure and

calculate the ankle-brachial index and realizes the

screening method for early diagnostics of peripheral

arteries diseases.

Comes with:

ABI Systems 100, angiological screening systems

with automated calculation

or BPI MD MESI (to be purchased additionally).

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* «Ankle-brachial index» Unit screen example

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Acuity of vision unit

The “Acuity of vision” unit applies

the method of the vision

acuity screening method using

the personal computer.

The unit measures the vision acuity within the range of 0,1 to 1,0.

Luscher test unit

The “Luscher test” unit is used

to carry out the color

and psychological test for:

• self-diagnostics and correction of own psychological state; • analysis of family conflicts and causes, which prevent from arrangement of the human being’s personal life; • control over the person’s will and emotions dynamics; • selection of candidates into psychotherapeutic groups for more adequate selection of psychotherapeutic exposure.

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*«Luscher test» unit screen example

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Choose the colour you LIKE

ECG-12 unit

“ECG-12” unit as a part of the system is used to

record electrocardiograms in 6 and 12 standard

leads with the duration of 10, 30 and 60 seconds.

Carries out automated measurements (testing

according to GOST RMEK 60601-2-25) and

generates ECG description. Distinguishes the

rhythm artificial driver’s impulses.

Comes with:

cardio-amplifier EC12C-01-CARDi2

with the set of chest and limb electrodes.

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electrodescardio-ampli�er

rack

cardio-ampli�er

a PC with the installed ECG-12 Unit

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PQ QRS

QT

BPM 49Angle QRS 36°PQ = 0.24 s P = 0.15 s QRS = 0.10 s QT = 0.50 s

- Junctional ST depression, probably normal.- Long QT interval.- Long PQ interval. Possible first-degreeatrioventricular block- Ectopic atrial rhythm.- Normal QRS axis.

00:00 00:01 00:02 00:03 00:04 00:05 00:06 00:07

I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

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“ECG-12” unit report page example

instant pulse value

automated measurements markers

automated measurements and ECG description

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Medicine department #1 -

10/23/2018 11:56 40 yearsDate of registration ECG Patient Doctor

76 78 80 82 81 78 78 78

STRESS-TEST unit

“Stress Test” is aimed at carrying out a simple load

test under the ECG-control in almost healthy

people with the risk factors, in sportsmen at the

sports specialization stage or at the stage of the

sports qualification improvement.

Testing of work efficiency and tolerance to the physical load using bicycle

ergometry (PWC170 tests, RAMP protocol) or using the Harvard step test. Bicycle

ergometry may be performed with the sum-maximum or the maximum loads till

stop. for cyclical sports and sport games, combat sports, for speed and strength

and complex coordinating sports. The maximum oxygen consumption (MOC) is

measure automatedly and compared to the standard values based on the sports

specialization.

*«Stress-test» unit load test

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4-electrode ECG in 6 standard leads is registered with EC6Ц-02-CARDi2/4

cardio-amplifier, which is a part of the HEALTH-EXPRESS HSS.GCЦ-02-CARDi2/4

The special belt allows placing the cardio-amplifier at the belt and minimizing

disturbances from the cable movement. The load is controlled automatedly at the

bicycle ergometer or set up by the computer rhythmometer during the step-test.

The unit maintains available KETTLER bicycle ergometers. Recommended for use

in SPORTS MEDICINE OFFICES equipped with according to Order No.134n of the

Ministry of Health Care of the Russian Federation, dated March 1, 2016.

AUDIT Test unit

“AUDIT Test” unit is used to identify alcoholic

addiction and its degree. The test has been

developed by the World Healthcare Organization

and widely used for over 30 years to identify

violations related to the alcohol consumption. The

opinion is generated automatically.

HADS Test unit

The hospital anxiety and depression score HADS

has been developed for primary identification of

depression and anxiety under the conditions of the

general medical practice. The HADS is used to

determine the level of anxiety and depression and

results in no obstacles for a patient or requires long

time for filling-out. The opinion is generated automatically.

Nicotine addiction level unit

The unit has been developed on the basis of

Fagestrem’s Test to identify the nicotine addiction

level and its degree, as well as on the basis of the

questionnaire of D. Khornu for identification of

this addiction type.

The opinion is generated automatically.

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Statistics unit

The “Statistics” unit is aimed at processing of

patients’ data bases with the automated selection

of patients groups by predetermined parameters.

«Express-Health STAND» Execution

A specially designed Express-Health Stand allows for generating up-to-date and compact

work environment and refuse from auxiliary equipment.

The stand contains checked computer components, a large touch screen for quick control

and a set of up-to-date network interfaces. The set up version of Windows OS for built-in

systems and industrial application ensures high reliability.

The whole range of HEALTH-EXPRESS HSS may be connected to the stand, and the

cardio-analyzer may be placed in a separate box cable and ECG electrodes put outside.

Built-in RFID optional unit allows identifying the patient by its personal medical record of the

CITIZEN OF MOSCOW/ SOCIAL CARD/ STUDENT’S CARD. This is a significant advantage for

conduction of examinations at educational institutions and at facilities. TEMPORARY CARDS

issued to the patient for identification during the comprehensive examination at various offices

can be also used.

One or several stands may be installed at various workplaces and combined with the single

data base of patients. Stands can be installed in public paces, e.g., in Health Centers’ halls.

In this case, patients may fill-out their medical records themselves, significantly unloading

medical offices.

17Round diagrams example

Micro-somatotype (slowed-down age development growth)Macro-somatotype (55)

(accelerated age development growth)

Мезомикросоматотип(номально-замедленные темпы возрастногоразвития)

Meso-macro-somatotype (37) (standard-accelerated age development growth)

Normal range (19)

Adaptation interruption (6)

Prenosological (52)condition

Premorbid (46)condition

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Statistics unit

The “Statistics” unit is aimed at processing of

patients’ data bases with the automated selection

of patients groups by predetermined parameters.

«Express-Health STAND» Execution

A specially designed Express-Health Stand allows for generating up-to-date and compact

work environment and refuse from auxiliary equipment.

The stand contains checked computer components, a large touch screen for quick control

and a set of up-to-date network interfaces. The set up version of Windows OS for built-in

systems and industrial application ensures high reliability.

The whole range of HEALTH-EXPRESS HSS may be connected to the stand, and the

cardio-analyzer may be placed in a separate box cable and ECG electrodes put outside.

Built-in RFID optional unit allows identifying the patient by its personal medical record of the

CITIZEN OF MOSCOW/ SOCIAL CARD/ STUDENT’S CARD. This is a significant advantage for

conduction of examinations at educational institutions and at facilities. TEMPORARY CARDS

issued to the patient for identification during the comprehensive examination at various offices

can be also used.

One or several stands may be installed at various workplaces and combined with the single

data base of patients. Stands can be installed in public paces, e.g., in Health Centers’ halls.

In this case, patients may fill-out their medical records themselves, significantly unloading

medical offices.

your institution name

built-in computer

multi touch screen

patient’s card reading area

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weight55 kg

Manufacturer:

Medical Computer Systems, LLCMoscow, 124460, Russia,4922, 4-2 Passage, ZelenogradTel.: +7 495 913 31 94E-mail: mks@mks.ruwww.mks.ru

Our official representative: