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Data-base management system on a CT scanner computer: application to teaching file and procedure records.

A prototype relational data-base management system was installed on computed tomographic (CT) scanner computers at two hospitals. This was used to create computerized indices for a teaching file and a record of CT procedures. Several problems commonly encountered when maintaining and using a radiologic teaching file were solved. Interesting cases were easily retrieved for teaching, conferences, or publication because the system permits rapid search on the basis of patient name, identification number, date, diagnosis, special description, or a combination of these data. The procedure record index contains these data as well as administrative and technical data on all CT examinations. These data are entered into the data base semiautomatically. The result is an extensive set of records that is easily accessible and requires a minimum of manpower to maintain.

Computers

An inexpensive computer-based digital imaging teaching file.

Despite a decade and a half of digital imaging in radiology, most radiology teaching files remain film-based. The reasons include the high cost or unavailability of digital acquisition and display devices. In the past few years, a number of excellent exhibits that combine inexpensive microcomputers with radiologic education have been shown at national meetings [1-6]. Unfortunately, many of these methods require esoteric hardware, expensive or proprietary software, or special programming skills. We developed a simple method for creating and disseminating a teaching file of imaging studies obtained with digital techniques.

Computer-Assisted Instruction

Web-based digital radiology teaching file: facilitating case input at time of interpretation.

OBJECTIVE: Our goal was to develop a software system that allows easy and rapid input of digital radiology images and text reports, at the time of interpretation, into an easily searchable electronic teaching file database using the Internet and the World-Wide Web protocols, servers, and browsers. CONCLUSION: Using the Internet, the World-Wide Web, and our software system, we can rapidly input digital radiology images and associated text reports into an easily searchable database accessed by privileged users. This inexpensive and simple method for building a digital teaching file database allows cross-platform access for users who have a Web browser.

Computer Communication Networks

A standard file format for data from DNA sequencing instruments.

There are now a number of machines for determining DNA sequences. These devices are currently of two types: those such as the Applied Biosystems 373A and the Pharmacia A.L.F. which interpret the sequences of samples as they run on gels within the machine, and those, such as the Bio-Rad and Amersham readers that scan and analyse conventional autoradiographs. Both types of machine can produce their data in the form of traces which represent the band intensity of each of the four base types at each position in the sequence. At present all the machines write files in different formats. We describe a machine independent format for storing data derived from automatic sequencing machines. Files in this format can store the derived sequence, the traces and a set of confidence measures for each base. We have adopted the format as the standard for our sequence handling software.

Databases, Factual

Graphic file compression on a Macintosh.

AutoDoubler, Compact Pro, DiskDoubler, StuffIt Deluxe, and StuffIt SpaceSaver compression applications for the Macintosh were tested for size of compressed files, and time to compress and expand. EPS, TIFF, PICT and Photoshop native format file types were used, in 1-bit, 8-bit greyscale, 8-bit colour (indexed), 24-bit colour (red, blue, green (RGB)), and 32-bit colour (cyan, magenta, yellow, black (CMYK)) modes. JPEG compression is illustrated by comparing an uncompressed image with three images compressed at different rates.

Computer Graphics

Reducing the volume of reports filed after discharge in the medical record department at Abbott Northwestern Hospital.

PROJECT: Decrease the backlog of "late" medical reports--ie, those sent to the Medical Record Department after the patient has been discharged and the patient's medical record has been received in the Department. Principals: Three teams: one composed of supervisor and staff of the records processing area; one of staff members from the Reception area; and one of staff members from the Laboratory, Radiology, and Special Diagnostics departments. Process Improvement Method: 10-step model based on Deming's key principles. Timeline: Begun: December 1991. RESULTS reported here: June 1992-September 1992. KEY FINDINGS: The systems for routing inpatient medical reports were faulty, so staff from the nursing units and ancillary services often sent reports to the Medical Record Department when the patient was still in the hospital. The process for locating and retrieving a chart for late report filing was too lengthy and complex. RESULTS: The backlog of unfiled reports has been reduced from 35 inches to less than one-half inch (an unusual, but customer-oriented measure). The time needed to file one inch of reports has decreased from 2 hours to 1.25 hours.

Documentation

Medicare program; date for filing Medicare cost reports--HCFA. Final rule.

This final rule extends the time frame providers have to file cost reports from no later than 3 months after the close of the period covered by the report to no later than 5 months after the close of that period. This change is necessary to ensure that providers have an adequate amount of time to file complete and accurate cost reports. We are also defining what HCFA considers to be an "acceptable" cost report submission.

Accounting

AHERF files for Chapter 11. Action may precede sale of nine hospitals to Vanguard.

Allegheny Health, Education and Research Foundation, one of the nation's brashest not-for-profit health systems, last week filed for Chapter 11 bankruptcy protection. The last-ditch move will allow Pittsburgh-based AHERF, which is $1.3 billion in debt, to restructure money-losing operations and pave the way for the sale of its nine Philadelphia-area hospitals. But the repercussions of the filing will be felt well beyond the state of Pennsylvania.

Bankruptcy

The Canadian Nutrient File.

Rapid Calculation of the nutrient content of foods and diets requires a current, easily accessible data base. The Canadian Nutrient File is a computerized information bank containing average values for nutrients in foods available in Canada. For easy accessibility, it contains subfiles for food names, nutrient names, and nutrient amounts. Users of the data should appreciate the limitations of this multi-use file.

Canada

Can a Chapter 11 filing keep hospital doors open?

Traditionally, a bankruptcy filing has been equated with failure: the inability of an organization and its management to 'make a go of it.' But the stigma of filing a Chapter 11 has gradually been fading since the bankruptcy code was revised. Today, a Chapter 11 can provide hospitals and other organizations with an opportunity to reorganize their operations and make a fresh and successful new beginning.

Financial Management

Security aspects of medical file regrouping for the epidemiological follow-up.

To carry out epidemiological studies at a regional level, one may need to link information collected by medical doctors working either in hospitals or in private offices or laboratories. The first problem is to respect the European legislation on nominal data processing, which does not allow the linkage of nominal files. As a consequence, we have developed an anonymous record linkage procedure, which ensures an irreversible transformation of identity and allows the linkage of rendered anonymous files. The second problem is to ensure data security during the transmission and we discuss the advantages of different methods of communication such as the norms X400 and Internet protocols.

Computer Communication Networks

Automatic and manual indexing performance in a small file of medical literature.

A test of the performance of an automatic indexing procedure based on the processing of the full text of medical journal articles shows results comparable to those achieved using Excerpta Medica and MEDLARS manual indexing. A file of nineteen documents was partitioned by sixteen questions, for each of which two search strategies in each indexing language were formulated. The results were compared to ideal answers chosen by a fourth-year medical student who read the entire file and posed the questions.

Abstracting and Indexing

[Scanning electron microscope study of chemically disinfected endodontic files].

Forty stainless steel endodontic files were observed at scanning electron microscopy after being subjected to ten disinfection cycles of 10 minutes each one, immersed in different chemical disinfectants. Corrosion was not observed on the surface of the files in circumstances that this study was made.

Corrosion

[S.E.M. study of surface condition of ultrasonic K files].

The present study was not about the interest of the association of ultrasonic instrumentation with irrigation in the root canal therapy, but about the wear of the K files themselves. The results showed with the assistance of the sono-synergistic system, files are almost as clean as the sterile are. This is important for the prevention of possible contamination.

Dental Cavity Preparation

[Magneto-optical disk filing system for oral diagnostic reports and their synchronized images].

The rewritable and compact media of magneto-optical disk (MOD) is firstly applied to store medical images with spoken reporting. The MOD has multi-media function of communication and filing. Our system is optimized in terms of recording length of speech based upon our clinical research. The results will have influences over the future PACS. One of their examples is possibility of multimedia PACS with images, speeches and demographic data. Another example is prevention of dispersion of images which have no interpretations by radiologists. Our next step is to recognize filed speech in background processing for printing reports.

Optical Storage Devices

Endodontic file design and dynamics in automated root canal preparation. Concepts, materials and methods.

Many treatment failures in endodontics are caused by problems that occurred during canal preparation. This article reviews principles of endodontic instrument design and analyzes the design as it relates to an automated handpiece. After a review of the problems of automation, there will be an introduction of a new automated handpiece and a new modified file known as the Anticurvature File.

Equipment Design

[Effects of paraformaldehyde steam sterilization on K-files].

Success of endodontic therapy depends upon both operator's skill and quality of the employed instruments. K-files have been examined for they probably are the most commonly used endodontic instruments. It is particularly important to take into consideration, together with the original quality of the instruments, its possible changes due to the wear from sterilization. In this paper have been therefore evaluated the characteristics of brand-new K-files from three different manufacturers together with the wear of the same instruments after paraformaldehyde steam sterilization.

Corrosion

[A new computerized system for electroencephalography at the Kochi Medical School Hospital: the present status and problems of electroencephalogram data filing systems].

The usual electroencephalography (EEG) recording consumes great amounts of paper, considerable storage space for records and much time and energy for their search and retrieval. In addition, we can not perform digitized analyses of the records with the present method. To solve these problems, our laboratory developed a new computerized system for EEG, in which data are retained in optic disks, and which has been in service for routine examination since December, 1988. The functions of the system and EEG filing system, include the collection, retention, retrieval, transmission and analyses of data with the reproduction of the original EEG and editing function of summary reports to be filed in the medical records. The summary report consists of summary, characteristic wave patterns picked up and edited from EEG, and spectral array and topographical mapping by digitized analyses of EEG. The condition for the collection of EEG data was 200 Hz/8 bit, and the reproduced wave patterns were accepted by all clinicians. The merits of the system include; (i) saving of paper, space and time needed for EEG, (ii) enabling the comparison of the wave patterns in the form of summary reports and (iii) the capability of digitized analyses of EEG by retaining the EEG data in the data base. The problems remaining to be improved for the system are the longer time required for examination (5-10 min) and the higher running cost (yen 460/order). Regarding the latter problem, a revised method which dispenses with recording paper is under consideration. That is, in the case of screening examinations, summary reports for medical records alone would be delivered to clinicians. This idea has been accepted by some clinicians. To realize the revised system, we presently are planning to establish a method to display EEG on CRT.

Data Collection