Biomedical subjects

M Fieschi

Publications and source records attributed to M Fieschi.

At least 37 records · Page 2Linked to original sources

PubMed2000

Modelling health care processes for eliciting user requirements: a way to link a quality paradigm and clinical information system design.

Hospital information systems have to support quality improvement objectives. The design issues of health care information system can be classified into three categories: 1) time-oriented and event-labelled storage of patient data; 2) contextual support of decision-making; 3) capabilities for modular upgrading. The elicitation of the requirements has to meet users' needs in relation to both the quality (efficacy, safety) and the monitoring of all health care activities (traceability). Information analysts need methods to conceptualize clinical information systems that provide actors with individual benefits and guide behavioural changes. A methodology is proposed to elicit and structure users' requirements using a process-oriented analysis, and it is applied to the field of blood transfusion. An object-oriented data model of a process has been defined in order to identify its main components: activity, sub-process, resources, constrains, guidelines, parameters and indicators. Although some aspects of activity, such as "where", "what else", and "why" are poorly represented by the data model alone, this method of requirement elicitation fits the dynamic of data input for the process to be traced. A hierarchical representation of hospital activities has to be found for this approach to be generalised within the organisation, for the processes to be interrelated, and for their characteristics to be shared.

Blood Transfusion↗

PubMed2000

The French Virtual Medical University.

This paper is the description of a French Virtual Medical University based on the federation of existing or currently being developed resources in several Medical Schools in France. The objectives of the project is not only to share experiences across the country but also to integrate several resources using the New Information and Communication Technologies to support new pedagogical approaches for medical students and also for continuing medical education. The project includes: A virtual Medical Campus using secure access from several sites, The Integration of new interactive resources based on pedagogical methods, Implementation of new indexing and search engines based on medical vocabularies and ontologies, The definition of general and specific portals, the evaluation of the system for ergonomics and contents.

Computer-Assisted Instruction↗

PubMed1999

Quality criteria and access characteristics of Web sites: proposal for the design of a health Internet directory.

The increasing volume of information available on the Internet today is a problem for health care professionals who want to access rapidly data of high quality. Usual search engines and directories are not sufficient to satisfy their needs. Moreover, the information published by Web sites is not always guaranteed. Some institutions around the word deal with the definition of a set of criteria for the evaluation of medical Web sites. We base our current work on the technologies we developed previously in order to integrate sources of information of various kinds using the "Unified Medical Language System" knowledge bases. This paper focuses on quality criteria and access characteristics Web sites should satisfy to be registered in a "Health Internet Directory". The design of such a system is proposed and discussed.

Abstracting and Indexing↗

PubMed1999

Confidentiality issues within a clinical information system: moving from data-driven to event-driven design.

Within a hospital, the moving of medical information systems from retrospective data-gathering methods to prospective clinical information systems raises the question of the confidentiality of patient data. A method of improving the traditional matrix model usually used to achieve access controls is described. The event-driven model refers to the way a security system ensures that a given user has a valid "need-to" relationship to a given patient. Events are defined as the occurrence of specific data that trigger the creation or the updating of the relationship between the identity of a user and the identity of a patient (e.g., admission, discharge, transfer, prescription, and report). The creation and the deletion of the relationships between users and patients are based on numerous repositories and working lists of patients. This implementation requires an organization of the hospital activities which is able to manage, in a real-time manner, those repositories as closely as possible to the steps occurring during the patient's care process. Although this approach seems to reasonably fit the dynamic of the care process, it adds significant organizational constraints.

Computer Security↗

PubMed1998

Modeling and implementing a database on drugs into a hospital intranet.

Our objective was to develop a drug information service, implementing a database on drugs in our university hospitals information system. Thériaque is a database, maintained by a group of pharmacists and physicians, on all the drugs available in France. Before its implementation we modeled its content (chemical classes, active components, excipients, indications, contra-indications, side effects, and so on) according to an object-oriented method. Then we designed HTML pages whose appearance translates the structure of classes of objects of the model. Fields in pages are dynamically fulfilled by the results of queries to a relational database in which information on drugs is stored. This allowed a fast implementation and did not imply to port a client application on the thousands of workstations over the network. The interface provides end-users with an easy-to-use and natural way to access information related to drugs in an internet environment.

Chemistry, Pharmaceutical↗

PubMed1998

ARIANE: integration of information databases within a hospital intranet.

Large information systems handle massive volume of data stored in heterogeneous sources. Each server has its own model of representation of concepts with regard to its aims. One of the main problems end-users encounter when accessing different servers is to match their own viewpoint on biomedical concepts with the various representations that are made in the databases servers. The aim of the project ARIANE is to provide end-users with easy-to-use and natural means to access and query heterogeneous information databases. The objectives of this research work consist in building a conceptual interface by means of the Internet technology inside an enterprise Intranet and to propose a method to realize it. This method is based on the knowledge sources provided by the Unified Medical Language System (UMLS) project of the US National Library of Medicine. Experiments concern queries to three different information servers: PubMed, a Medline server of the NLM; Thériaque, a French database on drugs implemented in the Hospital Intranet; and a Web site dedicated to Internet resources in gastroenterology and nutrition, located at the Faculty of Medicine of Nice (France). Accessing to each of these servers is different according to the kind of information delivered and according to the technology used to query it. Dealing with health care professional workstation, the authors introduced in the ARIANE project quality criteria in order to attempt a homogeneous and efficient way to build a query system able to be integrated in existing information systems and to integrate existing and new information sources.

Computer Communication Networks↗

PubMed1998

Implementation of a database on drugs into a university hospital Intranet.

Several databases on drugs have been developed worldwide for drug information functions whose sources are now electronically available. Our objective was to implement one of them in our University hospitals information system. Thériaque is a database which contains information on all the drugs available in France. Before its implementation we modeled its content (chemical classes, active components, excipients, indications, contra-indications, side effects, and so on) following an object-oriented method. From this model we designed dynamic HTML pages according to the Microsoft's Internet Database Connector (IDC) technics. This allowed a fast implementation and does not imply to port a client application on the thousands of workstations over the network of the University hospitals. This interface provides end-users with an easy-to-use and natural way to access information related to drugs in an Intranet environment.

Computer Communication Networks↗

PubMed1998

Conceptual integration of information databases into an Intranet.

Large information systems handle massive volume of data stored in heterogeneous sources of information. Each server has its own model of concepts representation with regard to its aims. One of the main problems encountered by end-users when accessing different servers is to match their own viewpoint on biomedical concepts with their various representations that are made in the database servers. The aim of the project ARIANE is to provide end-users with easy-to-use and natural means to access and query heterogeneous information databases. The objectives of this research work consist in building a conceptual interface by means of the Internet technology inside an enterprise Intranet, and to propose a method to realize it. Moreover, this method provides designers of web sites with a powerful tool to manage them on the basis of an ontology of the biomedical domain. This method is based on the knowledge sources provided by the Unified Medical Language System project of the U.S. National Library of Medicine and exploits intensively the conceptual graphs theory.

Computer Communication Networks↗

PubMed1998

A collaborative approach to building a terminology for medical procedures using a Web-based application: from specifications to daily use.

The MAOUSSC (Model for Assistance in the Orientation of a User within Coding Systems) Web server supports a collaborative work on the description of medical procedures. The specifications for the MAOUSSC application are conceptual modeling, definition of semantically fully described procedures, re-use of an existing vocabulary, the UMLS, and sharability. This paper reports on some difficulties in applying those principles in a networked building and updating of the terminology. The users are physicians who have to represent procedure terms in the MAOUSSC formalism. They must apply the constraints of the underlying model, and re-use the representation of the UMLS knowledge base. In our experience, we found that the implementation of syntactic and semantic constraints was not sufficient. Guidelines for pragmatical aspects in representation are required to make a collaborative approach in terminology building more operational.

Humans↗

PubMed1998

Impact of the TOP-FORUM hypermedia system in a pediatric oncology care unit.

This paper describes our approach in analyzing the impact of the TOP-FORUM hypermedia in a pediatric oncology care unit. The impact of this technology is realized through the study of accommodation and assimilation adoption. Accommodation refers to the technological adoption and Assimilation refers to the professional adoption. Results show that accommodation depends on information and formation of the users. Assimilation is more difficult to evaluate because it depends on human, social and organizational problems.

Attitude of Health Personnel↗

PubMed1998

Towards semantic integration within an existing medical information system.

Talking about the problems of integration in medical information systems, the necessity to provide end users with a consistent and coherent view of patient's data, has been largely reported. In order to attempt this goal, systems need to perform semantic integration. We propose a pragmatic way to describe the semantics of the elements of a database, based on a bottom-up three steps process: 1. a back documentation of the elements of the system from their description contained in the data catalog of the database 2. a first semantic extension to transform a data catalog into a data dictionary 3. a second semantic extension to create a dictionary of the medical concepts from a data dictionary. This dictionary of concepts can be considered as the final result of "semantic integration". It contains a set of entities directly understandable by the end users. These entities are deduced or built from the elements collected and characterized in the data dictionary. This work reports the conceptual analysis and the implementation of such a data dictionary.

Database Management Systems↗

PubMed1998

Review of biomedical knowledge and data representation with conceptual graphs.

The basis of conceptual graphs theory is an ontology of types of concepts. Concepts issued from the ontology are interlinked by semantic relationships and constitute canonical conceptual graphs. Canonical graphs may be combined to derive new conceptual graphs by means of formation rules. This formalism allows to separate knowledge representation into a conceptual level and a domain-dependent level, and enables to share and reuse a representation. This paper presents conceptual graph applications to biomedical data and concept representation, classification systems, information retrieval, and natural language understanding and processing. A discussion on the unifying role conceptual graphs theory plays in the implementation of knowledge-based systems is also presented.

Artificial Intelligence↗

PubMed1998

Towards interoperability of information sources within a hospital Intranet.

Information is usually available in heterogeneous data format and various legacy sources. Interoperability appears to be a major approach for applications to access information. The project ARIANE is devoted to provide end-users with an easy to use and natural access to information databases. In this frame we defined actors able to operate the mediation between end-users and information servers: a "broker" which selects appropriate resources and "mediators" which access data suppliers. We have implemented a web-oriented stand-alone prototype accessing three types of information sources: a bibliographical server, a SQL database server and a hypertext server. Both broker and mediators exploit the Unified Medical Language System knowledge sources, especially the Information Sources Map which allows a way to identify information servers.

Computer Communication Networks↗

PubMed1997

Critical dimensions in medical informatics.

A typology of medical informatics applications is proposed around three dimensions: the dimension of care, the dimension of information and knowledge, and the aspects of the computerized society. These dimension can help both to evaluate application or research papers in the field or to derive long term goals for the discipline. In the first dimension medical informatics appears more as a technology driven by external forces such as the general progress of medicine or the integration of economical constraints in the choice of optimal procedures. It is argued that barriers to overcome as well as challenges for future research mainly remain in the two last dimensions.

Artificial Intelligence↗

PubMed1997

Designing medical hypermedia: the FORUM project.

Medical activity in learning stages or in usual tasks is a wide field for information technologies. But it would be a mistake to focus on technologies and minimize the organisational, social and cultural aspects of integrating such technologies. Medical hypermedia design based only on a technological approach is a case in point. This paper describes our experience in hypermedia development. It reports on the technical, methodological and organizational aspects destined to help the medical community get involved in the development of such applications.

Computer Communication Networks↗

PubMed1997

A UMLS-based method for integrating information databases into an Intranet.

The Internet and the World Wide Web provide today end-users with capabilities to access universally to information in various and heterogeneous databases. The biomedical domain benefits from this new technology, specially for information retrieval by searching and browsing various sites. Nevertheless, end-users may be disoriented by specific ways to access information on different servers. In the framework of an Intranet design and development, we present a method for integrating information databases based on knowledge sources of the UMLS. The method provides designers of a Web site with facilities to implement an easy and homogeneous access to information. The pages are built dynamically and displayed according to a style sheet and their content stored in a database during the design phase. The database also describes the links between pages. Moreover, this organization provides administrators with powerful capabilities to manage Web sites.

Databases as Topic↗

PubMed1996

[The multimedia workstation, electronic assistant to the health care professional].

The health professional multimedia workstation is the natural entry point to health and knowledge networks. It should allow an easy and transparent management of all the data necessary for patient management. Multimedia nature of processed information reflects evolution of medical techniques that involve more and more complex objects such as video sequences or digitized signals. Workstations can be considered from 3 points of view: the professional end-users, the developers and the decision makers. The long term goal for the end-user is to establish an easy access in a working environment, that gives him/her the feeling of a single comprehensive application running on a single computer when the information system relies on a set of heterogeneous and geographically distributed components. Development of a workstation requires the integration into the same environment of tools to localize, access, manipulate and communicate the required information within a health information network. Analysis of the 445 Medline-indexed publications for the January 1991 to December 1994 period, that included the word workstation either in their title or in their abstract, helps in refining objectives and challenges both for the health professionals and the decision makers.

Computer Terminals↗

PubMed1996

[Informatics and evaluation of the medical activity].

Medical activity is characterized by its complexity. Professional guidelines and good wills do not suffice to improve efficiently performances of decisions taken by health care workers, medical doctors and administrators. The evaluation medical activity is a necessity for assisted decision making. The finality of evaluation has to be specified, its methods must be adapted, so that it is accepted by the medical community. In this framework, data processing can be a tremendous way to improve continuously the efficiency of the health care system.

Delivery of Health Care↗