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Cardiomedia: a multimedia portable medical record on optical memory card.

The main objective of the CARDIOMEDIA project is to produce and evaluate a coronarian multimedia data record stored on an optical card. The experimentation concerns patients treated by angioplasty at university hospital of Rennes. Often patients treated in the Regional University Hospital are followed up by another Health structure closer to their home. The patient leaves hospital with his card, which is directly available elsewhere for emergency or for consultation. This will optimize the number of examinations and offer a better patient follow-up. The CARDIOMEDIA card is a specialized record which includes various data type: text, image, image sequence of coronarography and ECG signal. For this purpose optical card with its large memory size is very convenient. For medical imaging, we use in this project the DICOM format for image exchange and management, it is combined with a CARDIOMEDIA specific compressing software. For multimedia record, the HTML format and web intranet method are chosen, this allows intuitive interface which can combine various data type and helpers like DICOM image viewer.

Cardiovascular Diseases↗

A novel method for storage of medical records and documents.

Many medical groups have a problem storaging and managing inactive medical records. The storage process involves selecting the records from inactive status, moving the records to storage and retrieving them if the patient is re-established. Many groups simply run out of storage space and are in need of an efficient and cost-effective way to manage this problem. This case study will show that an optical storage system provides a cost-effective method of archiving medical documents that can be easily indexed and retrieved.

Group Practice↗

On stepwise integrating an electronic patient record based on digital-optical archiving and multi-purpose health professional workstations: experiences at the Heidelberg University Hospital.

At the Heidelberg University Hospital the conventional paper-based medical record is currently being replaced by a "unique" electronic patient record (EPR). This paper describes the stepwise integration of an EPR based on digital-optical archiving and multi-purpose health professional workstations. If focuses on the potentials of digital optical archiving as an integral part of hospital information systems. So far, the EPR has been introduced in the central archive of the "head clinic", the Neurosurgical Clinic and the inpatient archive, the endoscopy and sonography section of the Department of Internal Medicine.

Computer Systems↗

More space, more speed. Scanning technology and COLD help improve document imaging.

UNLABELLED: Children's Hospital Medical Center, Akron, Ohio PROBLEM: The 100-year-old-plus medical center needed a reliable, economical and easy-to-use document storage method that provided a long and secure archival life. SOLUTION: Children's adopted Hewlett-Packard magneto-optical jukeboxes and Optika software. RESULTS: Since the jukeboxes became operational in January 1998, Children's has maintained "24 x 7 availability" of its stored documents for up to 150 concurrent users without any downtime. KEYS TO SUCCESS: "We started implementation in the accounting department with patient billing, hospital general ledger, accounts payable and employee payroll, and the document imaging system has quickly gained acceptance in other departments as well."

Hospital Information Systems↗

Image is everything.

Digital imaging is transforming the practice of radiology. But provider organizations face many technical and financial challenges on the road to becoming filmless. Their own reluctance to let go of the film habit is making the transition to digital images difficult. And the complexity of the myriad technologies, as well as the high prices delivery systems and hospitals still must pay to acquire them, are slowing the march toward filmless radiology departments.

Capital Expenditures↗

[Past, present and future of optical cards for medical use].

In the hospital, the chart is an important medical information record. However, it is not easy to refer to chart records. Although a computer is useful in referring to the chart, the most critical defect is the lack of exchangeability between hospitals. An optical card is a new medium for medical use. It has a large capacity for electronic storage, low price and high security. Therefore, the author considers this card a second medical chart. As another card, there is the IC card, which has some limitations in medical use. Although both systems are being examined experimentally, there is no actual practice in the medical field. The reason for this lack of wide use, it is thought that these systems are not yet supported by national health insurance.

Computer Communication Networks↗

[Development of perinatal management system using optical card and regional health information network].

In Kagawa Prefecture, a perinatal management system using the optical medical card and the information network has been introduced since October 1998. Four hospitals(Kagawa Medical University, Sakaide Municipal Hospital, Uchinomi Town Hospital and Tsuda Prefectural Hospital) are connected with each other through the health information network(Kagawa Health and Welfare Information Network) organized by Kagawa Prefecture. (http://www.hw.kagawa-swc.or.jp/net/) Patients' clinical data are described on the optical card based on the "standard format of the Japan Association of Obstetricians and Gynecologists(JAOG). (http://www.jaog.or.jp/JAPANESE/MEMBERS/JOUHOU/H10/index.htm). Clinical information including the fetal heart rate(FHR) and sonography (JPG) can be easily transmitted through this network(on line). Without the network, patient data can also be transmitted using the optical card(off line). There are still many technical and social problems to be solved in the future, research into the use of medical information network should be continued.

Computer Communication Networks↗

[On standardization of optical memory cards].

An optical card optimizes recording of medical data since it has a large memory capacity, data cannot be interpolated by the addition method, and data are protected from disruption by magnetic force or static electricity. Now that international standards have been established for the card, reader/writer control, and data management, a highly-compatible optical card system for medical use can be fabricated. The optical card is expected to play an important role in the social system as a promising medium for recording or exchanging individual health data, which is anticipated to grow in the near future.

Computer Communication Networks↗

Feasibility and clinical value of "intelligent" compression and digital storage of transthoracic echocardiograms in day-to-day practice.

BACKGROUND: The aim of this study was to assess the clinical concordance of expert cardiologists' interpretation of echocardiographic studies recorded on Super-VHS videotape or stored in magneto-optical disk, as well as the feasibility and clinical value of intelligent compression and digital storage of echocardiographic data as cine-loops and still-frames for interpretation of transthoracic echocardiographic images in clinical practice. METHODS: All clinical cardiologists experienced in echocardiography in our department (n = 10) reported on a standardized worksheet checklist the echocardiographic data of 7 consecutive patients (140 reports), and recorded them on videotape or magneto-optical disks to compare the interpretation of videotaped studies, acquired in the usual way, with clinically compressed studies stored to magneto-optical disks using a standard (Italian Society of Echocardiography) image acquisition protocol. RESULTS: The time interval between analog and digital study readings was 50 +/- 15 days. Except for tricuspid valve regurgitation grading (k = 0.28) and for left ventricular global hypokinesia (k = 0.32), the intraobserver agreement in the interpretation of the 3290 cardiovascular morphological and functional findings found on analog and digitally stored images was good (k value ranging from 0.66 to 1.00). The wall motion score index was 1.56 +/- 0.53 when interpreting analog studies, and 1.52 +/- 0.54 on digital studies (p = 0.35). Conversely, the interobserver variability of the wall motion score index (Gini index ranging from 0 to 0.80) was significantly lower when interpreting studies stored digitally than when analog ones were examined (0.48 +/- 0.021 and 0.52 +/- 0.023 respectively, p = 0.006). In comparison to videotape recordings, digital storage of echocardiographic studies significantly shortened the time to image access for study review (327 +/- 62 and 30 +/- 4 s, respectively, p < 0.0001) and the reading time (600 +/- 300 and 540 +/- 300 s respectively, p = 0.034), rendered study accessibility easier (difficult or good: 73 vs 43% of observers, fast or optimal: 27 vs 57% of observers respectively, p = 0.0011) and improved the recorded image quality perception (poor: 25 vs 10% of observers, sufficient or good: 75 vs 90% of observers respectively, p = 0.022), without loss of study completeness (insufficient: 18 vs 17% of observers, adequate or complete: 82 vs 83% of observers, respectively; p = NS). Finally, from September 1, 1999, digital storage has become routine practice for patients admitted to our Department. By December 31, 1999, 411 echo studies had been stored: 7 +/- 3 cine-loop/study, 32 +/- 18 frames/cine-loop, and 3 +/- 2 still-frames/study. The average amount of memory needed for storage was 18.6 +/- 11.9 MB/study. CONCLUSIONS: Clinical compression of echocardiographic studies seems to be an accurate summary of the complete examination recorded to videotape for the assessment of patients admitted in the coronary care unit. In addition, digitally stored studies allow a significant improvement in the interobserver reproducibility of wall motion score assessment.

Analog-Digital Conversion↗