A Web-based electrocardiogram (ECG) monitoring service in which a longitudi
nal clinical record is used for management of patients, is described. The W
eb application is used to collect clinical data from the patient's home. A
database on the server acts as a central repository where this clinical inf
ormation is stood. A Web browser provides access to the patient's records a
nd ECG data. We discuss the technologies used to automate the retrieval and
storage of clinical data from a patient database, and the recording and re
viewing of clinical measurement data. On the client's Web browser, ActiveX
controls embedded in the Web pages provide a link between the various compo
nents including the Web server, Web page, the specialised client side ECG r
eview and acquisition software, and the local file system. The ActiveX cont
rols also implement FTP functions to retrieve and submit clinical data to a
nd from the server. An intelligent software agent on the server is activate
d whenever new ECG data is sent from the home. The agent compares historica
l data with newly acquired data. Using this method, an optimum patient care
strategy can be evaluated, a summarised report along with reminders and su
ggestions for action is sent to the doctor and patient by email. (C) 1999 E
lsevier Science Ireland Ltd. All rights reserved.