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At least 217 records · Page 12Linked to original sources
PubMed1992

Experience with an operational nuclear medicine PACS in the Utrecht University Hospital.

At the department of nuclear medicine of the University Hospital Utrecht a single modality PACS has been operational since mid 1990. After 1 year of operation the functionality, the organizational and economical consequences and the acceptability of the PACS are evaluated. The functional aspects reviewed are: viewing facilities, patient data management, connectivity, reporting facilities, archiving, privacy and security. It is concluded that the improved quality of diagnostic viewing and the potential integration with diagnosis, reporting and archiving are highly appreciated. The many problems that have occurred during the transition period, however, greatly influence the appreciation and acceptability of the PACS. Overall, we feel that on the long term there will be a positive effect on the quality and efficiency of the work done in our department.

Computer Communication Networks↗
PubMed1995

Pathways.

Hospital Information Systems (HIS) in their various forms are receiving wider acceptance and recognition due to the overwhelming global need to improve the efficiency and cost effectiveness of the provision of health care. Many of the technological limitations of the past have been, or are being, overcome. This makes HIS viable and extremely valuable to all members of the health care delivery team. Due to the magnitude of investment in the implementation and support of HIS, in terms of both financial and human effort, and the rapid rate at which information technology is developing, hospital managers in many parts of the world face the dilemma of whether to invest in HIS now or wait a little longer until the development has 'settled down' and become more affordable. We are certain of two things with respect to information technology (IT); these are that hardware technology will continue to develop at an ever increasing rate, and that the cost thereof will continue to decrease, to the extent that many are of the opinion that the IT revolution is now upon us. The question of whether an evolutionary or revolutionary development in HIS will ensue continues. It is believed that financial considerations will dictate. It is however generally accepted that a fast-track evolutionary development in HIS will take place due to the need to protect the investments of the past, and organisational dependence on operational HIS.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗
PubMed1995

European standards development in healthcare informatics: actual and future challenges.

This paper focuses on the current and future standardisation activities in CEN TC251 (European Standardisation Committee, Technical Committee on Medical Informatics). The progress of the Committee's standards development is summarized per working group. The main challenges of the next years are enumerated: coordination across working groups and project teams, quality management, and international harmonisation (especially with the USA).

Accreditation↗
PubMed1995

The status of healthcare standards in the United States.

Healthcare standards in the US are produced by six standard developers organizations: ACR/NEMA, ASC X12N, ASTM, HL7, IEEE, and NCPDP. The activities of these groups are coordinated through the ANSI HISPP. While considerable progress has been made in the area of data interchange standards, little progress has been made in the area of vocabulary standards.

Computer Communication Networks↗
PubMed1995

Healthcare Information Framework.

CEN committee TC 251 Medical Informatics, has set up a project team charged with producing a European pre-standard ENV on Healthcare Information Framework (HIF). The HIF is based on abstraction from a specific information system architecture to a reference architecture and further to a conceptual architectural framework based on serving open, distributed and heterogeneous healthcare enterprises. To specify the suitable healthcare information system architecture modelling of the healthcare enterprise is required. As there is no one method serving all needs, the HIF gives guidance on what aspects to look at in selecting a suitable modelling method. It is expected that the work will be completed by early 1995.

Artificial Intelligence↗
PubMed1995

The health care professional multimedia workstation: development and integration issues.

Workstations for health care professionals provide access to distributed healthcare information systems. They are complex systems that have to manage, in a unified framework, the distributed and multimedia information needed for optimal patient care. The objective is to provide the end-user with a virtual and unified device that conceals the complexity of the underlying information system. Integration and reuse of modular software components are important in the development of such a workstation. A reference set of evaluation criteria is proposed that includes functional, technical, organizational, medical, cultural and ethical, economic and industrial components.

Computer Communication Networks↗
PubMed1995

Security in hospital information systems.

The paper links the previous and proposed activities of IMIA WG4 with the developments of IMIA WG10. The fading systems boundaries, increasing and integrated functionality together with the increasing use of information within HIS to care for patients raises the questions of whether HIS should be treated as 'safety critical' systems or medical devices and tested appropriately. These considerations immediately lead to the need to establish appropriate security standards for HIS.

Computer Communication Networks↗
PubMed1994

Health care professional workstations: where are we now? ... where should we be tomorrow?

This article looks back over four years during which major changes have occurred in healthcare informatics, both technically and from a policy perspective. A remarkable portion of what medical-informatics professionals were proposing in 1989 has subsequently come to pass. Thus, one lesson from reflections on the recent past is that now is the time for us to devise realistic expectations of what we will see happen in the next four years. Possible scenarios for the future are outlined, as are suggestions for how the informatics community might best prepare for what lies ahead.

Computer Communication Networks↗
PubMed1994

In front of us.

The care of patients is an information-intensive activity in which a large number of decisions must be made. Through the support of more rapid, less expensive, and better decisions, workstations can contribute positively to the science, the art, and the economics of health-care. They have greatest potential value when they have access to a large amount of information relevant to the decisions which must be made jointly by patients and their care providers. Technological and psychological barriers to the acceptance of workstations are becoming increasingly surmountable. Workstations may increase patients' satisfaction with the care they are provided, reduce the total cost of care, and reduce the cost of clinical information to third parties, by economically enabling comprehensive, up-to-date, and accurate medical records from which information can be rapidly and cheaply extracted and made accessible to all who need to use it.

Computer Communication Networks↗
PubMed1994

Design and processing issues for the health care professional workstation: summary and recommendations.

The health care professional workstation is a window to a heterogeneous set of functions that need to be ported to various types of hardware for different types of users. Processing aspects, which belong with the interface, storage and communication, to the architectural dimension of the workstation should not be considered outside of a more comprehensive model including the user, function and time dimensions. Several recommendations, which could provide the appropriate environment for development and help maintain a viable approach as the variables change along the four dimensions of the workstation model, are proposed. They concern the adaptation of the enterprise infrastructure to integrate workstations, the need for a reference architecture for health care workstation development and recommendations for the evaluation and dissemination of results.

Computer Communication Networks↗
PubMed1994

Defining clinical 'workstation'.

Interest in the physician's workstation has increased, yet often seems to focus on technological issues. At Boston's Beth Israel Hospital, the Center for Clinical Computing includes heavily used clinical workstations. Their evolution over the past 20 years suggests design criteria: the workstation must be patient-centered, the interface must be uniform, and data acquisition must be addressed at a system level. However, it is clinical function that really defines a workstation. The workstation should do the following: display patient information rapidly and flexibly; assist with administrative tasks; facilitate communication; and provide four important types of decision support: access to literature, access to databases, clinical calculation, and 'synthetic vision,' or different views of patient data. The solutions to our healthcare problems are not in 'workboxes' we can buy, but in creative approaches we can imagine. We need a patient-centered infrastructure and a reduced workload for the clinician-perhaps a 'worklesstation'.

Computer Communication Networks↗
PubMed1994

An architecture for a health care provider's workstation.

This paper presents an architecture for a health care provider's workstation designed to assist health care providers in performing their daily activities. The design is based on the concept of a clinician's associate which acts as an intelligent intermediary between the provider and a diverse collection of clinical, administrative, and educational information sources. The architecture is designed to be hardware platform independent, to work across different I/O capabilities, and to be open, allowing specialized applications to be easily integrated with the system and their functionality delivered through a common user environment.

Computer Communication Networks↗
PubMed1994

Sharing and communicating health care information: summary and recommendations.

Sharing and communicating information is a fundamental task in modern medicine. The health care system of the western world is based on teamwork of professionals who participate in the care of patients. Exchange of information (not just data) requires the communicating parties to agree on a communication channel, an exchange protocol, and a common language. The language includes an alphabet, words, phrases, and symbols that express and assign meaning, understood by all. The most common forms of communication are the spoken word and the paper-based patient record. Computers and communication systems improve the sharing of health care information by overcoming the limitations imposed by the dimensions of time and location. However, natural language is still too complex and too ambiguous for current computing devices to handle the complex interactions between health care professional and patients. A simpler 'language' is needed that uses domain specific vocabularies (and/or codes), well-defined exchange protocols for data, information, knowledge, and, in the future, perhaps even wisdom. This simpler 'language' is expected to handle most of the routine information exchange but not eliminate natural language. It is essential that health care information systems preserve and incorporate natural language expressions and integrate them with structured vocabularies. Today, agreeing on standard data exchange protocols and domain specific vocabularies and codes is our greatest challenge. However, standards alone are not sufficient. Acceptance of the standards by the health care professionals, verifications in clinical environments, and implementation agreements by the medical informatics industry are essential. The group on 'Sharing and Communication of Health Care Information' addressed the issues raised above and unanimously recommends a number of steps that will improve the sharing of information. In addition, specific recommendations are offered to governments, health care institutions, and to developers of health care information systems.

Communication↗
PubMed1994

A model for the assessment of medical workstations for health care support.

The development of medical workstations for the support of patient care, the assessment of care, management support, and education is just at its beginning. During the Working Conference on the Health care Professional Workstation held in Washington DC, June 1993, several aspects of such workstations were discussed, but it was also recognized that prototyping or learning by experience could be a rich source to further promote the progress in this field. Eight such prototypes or already operational medical workstations were demonstrated and a preliminary user assessment was done to obtain a first insight in the advantages and the type of criteria of such evaluations. It was concluded that such assessments were of great value to (i) give feedback to the designers of medical workstations, (ii) indicate areas of strength and for further research, and (iii) to offer criteria to potential users of such workstations for making decisions on using such systems. The assessment criteria deal with functionality, architecture, user interfaces, communications and integration, and data and knowledge management.

Artificial Intelligence↗
PubMed1994

New opportunities for processing the OSI-7 layer protocols using parallel processing (transputers).

The attractiveness of the OSI-7 layer model is closely dependent upon a highly ambitious intent to promote a series of quasi-universal standards to coordinate the communication between heterogeneous applications, whatever the distributed architectures might be. However, a major criticism of the OSI-model is the performance and the handling of the presentation layer. This paper deals with the evaluation of parallel processing techniques operating at the upper levels of the OSI-model using transputers in a parallel co-processor. It is shown that the performance problem is highly dependent on the structure of the protocol stack and its implementation. With the object-oriented modularization of the protocol stack, an architecture of a possible co-processor using transputers is considered and its performance is considered adequate. An ideal configuration is briefly presented. A final performance appraisal of the parallelism effect is discussed with some insight into the future.

Computer Communication Networks↗
PubMed1994

Software for the analysis of mutations at the human hprt gene.

Mutations at the human hypoxanthine-guanine phosphoribosyl transferase gene (hprt) are currently of great interest because mutations at this locus are being used as a biomonitor of human mutagenic exposure. Not only can somatic hprt mutants arising in vivo in humans be recovered and sequenced, but there is also a considerable body of information about the in vitro mutational spectra of different carcinogens at this locus. Previously, we reported the creation of a computerized database containing DNA-sequence information on human hprt mutants (Cariello et al. (1992) Environ. Mol. Mutagen., 20, 81-83). In the present manuscript, software for the analysis of mutations in the hprt database is described. Numerous routines have been developed for the analysis of single-base substitutions, including programs to (i) determine if two mutational spectra are different, (ii) display the number of mutations and mutable sites in each exon, (iii) determine if mutations show a DNA-strand bias, (iv) determine the frequency of transitions and transversions, (v) display the number and kind of mutations observed at each base in the coding region, (vi) perform nearest-neighbor analysis and (vii) display mutable amino acids in the hprt protein. The software runs only on IBM-compatible machines with MS-DOS. The software and hprt database is freely available via the INTERNET using remote file-transfer protocol. These programs simplify the analysis of the rapidly increasing information about hprt mutation. The programs permit the facile comparison between in vitro and in vivo data, as well as the identification of mutational patterns that may be of importance to experimenters using hprt as a biomonitor and and of importance to researchers studying mechanisms of mutation.

Amino Acids↗