ISO 22077-3:2023

Overview

ISO 22077-3:2023 - "Health informatics - Medical waveform format - Part 3: Long-term electrocardiography" defines how to apply the Medical Waveform Format Encoding Rules (MFER) to long‑term ECG recordings. Published in 2023, this ISO standard specifies the structure and encoding conventions needed to describe ambulatory and monitoring ECG data (bipolar 2‑, 3‑lead and 12‑lead) captured by devices such as Holter electrocardiographs and patient physiological monitors that are compatible with MFER (see ISO 22077‑1).

Key topics and technical requirements

This Part 3 document focuses on practical encoding rules and includes:

• Encoding format: primary description for long‑term ECG and optional waveform recognition, measurement and interpretation metadata.
• Sampling attributes and frame attributes: rules for representing sampling conditions and frame-level metadata for synchronization and display.
• Waveform class and data alignment: mechanisms to align multi‑lead signals and ensure proper temporal correspondence across channels.
• Data encoding: formats for recording waveform samples, and for representing processed and raw data.
• Recorder and scanner encoding: roles and data exchange between wearable recorders and analysis scanners (retrieval, editing, reporting).
• Lead name and lead calculation: standardized ways to identify leads and describe calculated leads derived from recorded channels.
• Filter information: documentation of filters applied to waveforms and how filter usage is represented.
• Conformance and examples: Annex A provides an MFER conformance statement; Annexes B–D include encoding guidance, examples and coding tables.

The standard builds on ISO 22077‑1 (MFER encoding rules) and references normative implementation requirements from that part.

Practical applications and target users

ISO 22077-3 is intended for:

• Medical device manufacturers (Holter recorders, bedside monitors) implementing MFER-compatible output.
• Software vendors who develop ECG analysis, storage or viewing applications (scanners, EMR integrations).
• Clinical engineers and IT teams integrating waveform data into Electronic Medical Records (EMR) and hospital systems.
• Researchers and vendors needing interoperable long‑term ECG data for arrhythmia analysis and longitudinal studies.

Benefits include improved interoperability, consistent long‑term ECG encoding, easier EMR integration, and reliable multi‑vendor data exchange for archival, analysis and clinical reporting.

Related standards and integration

ISO 22077-3 is part of the ISO 22077 series and is designed to be used alongside other healthcare standards for non‑waveform data, such as HL7 (CDA), DICOM, IEEE formats and SCP‑ECG (ISO 41064). For implementation, follow ISO 22077‑1 for core MFER rules and use the conformance statement (Annex A) to demonstrate compatibility.