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PubMed1986

First in the neighborhood. Experience with a LAN.

Once an office obtains several microcomputers, the purchase of a local area network (LAN) may be considered for a variety of reasons: sharing of hardware such as hard disks, printers, and back-up systems and sharing of information either in files or through electronic mail. The purchase of such a system requires a more specific analysis of needs than the decisions required for purchase of one's first microcomputer. This article outlines many of those considerations through a case study of the purchase and operation of a LAN in a university research setting.

Academies and Institutes↗
PubMed1993

Improving the efficiency of patient recruitment with an automated telephone screening system in a client-server environment.

An automated telephone screening system was implemented at the Baltimore VA Hospital on a Local Area Network (LAN) to evaluate older adults for the GRECC research program. Using the system for decision support, a registered nurse (RN) placed 117 phone calls to older adults in the Baltimore community over a 3 month period. The modular design of the system allowed tracking of inclusion and exclusion criteria which was shared by clinicians and researchers. The design goal of the telephone screening system was to reduce time and personnel costs and increase the effectiveness of screening for recruitment for a major research project. Effectiveness is defined as avoiding under--or over--screening. Using the telephone system, it is estimated the research team saved over $6,000.00 in unnecessary medical evaluation in a 3 months period. As the system develops, the process by which older adults are assessed for research programs in the Geriatrics Service at the Baltimore VAMC will provide additional cost efficiencies.

Aged↗
PubMed1993

[Electronic data processing in urologic clinics. Results of a survey. Electronic Data Processing in Urology Group of the Graduate and Continuing Education Commission of German Urologists].

Computer equipment in Departments of Urology in Germany was evaluated by a nation-wide questionnaire. One hundred and fifty-three questionnaires were returned with detailed information on computer hardware, software and applications in Urology. Most departments were equipped with at least one computer. Computer equipment varied considerably among the participants including both stand alone personal computers (PCs) and local area networks (LANs) with several PCs connected by cable. Typically, PCs were IBM-compatible and ran the MS-DOS operating system Word processing and related applications were the most frequently mentioned computer tasks in urology. In some departments computers are also used in research for production of databases and graphics and for statistical applications. When computers were used for documentation of therapy and/or medical records, software was often custom-made according to the department's specific needs. In the future, more computers will be needed in departments of urology, because medical records will have to meet higher standards of documentation.

Computer Literacy↗
PubMedDate not supplied

Driving down the electronic highway.

Life as a computer lab coordinator is never dull nor routine. No sooner do you become comfortable with computer-aided instruction (CAI), computerized testing, interactive video systems, and local area networks, than do you face a new challenge. As faculty and students become more sophisticated in learning how to use computers, interest in accessing large, international computer networks increases. This article describes the available resources, and both the rewards and problems associated with preparing yourself to teach nursing students about the Internet, a large, global association of government, academic, and research computer networks.

Computer-Assisted Instruction↗
PubMed1993

Implementation of a personal computer (PC) as a graphic station into the system MicroDELTA-MaxDELTA for processing of nuclear medicine images.

One of the possibilities to integrate PC into the system "MicroDELTA-MaxDELTA" for acquisition and nuclear medicine image processing is introduced. A 386 IBM compatible personal computer is connected into the local area network with MicroVAX II, which is the part of a "MicroDELTA-MaxDELTA" system. "NuMed" application, which enables simple and efficient manipulation of patient studies and also their archiving, processing and generating reports, is developed in WINDOWS environment. Considering the fact that existing system fully satisfies the acquisition requirements, the whole conception has the aim to upgrade the digital image processing, and initiate further development of the whole system.

Computer Systems↗
PubMed1995

Design and implementation of an electronic point-of-contact oncology clinical record.

An electronic point-of-contact narrative clinical record was developed and implemented in a multidisciplinary regional cancer center with an annual new caseload of 1,200. Design principles included (1) natural clinician-intuitive interface with pen, touch, and sound input options; (2) structure and processes enabling direct input of both clinician-reported and patient-reported data; (3) embedding of decision support and practice guidelines directly into the interface; (4) incorporation of automated cancer staging algorithms; (5) automatic production of consultation and progress notes, limiting transcription requirements to sound fields; (6) outcomes--focused report formats; and (7) integrated billing and activity reporting. The system was implemented in Windows, both on a local area network and on mobile devices. Evaluation parameters included feasibility, acceptance, performance, cost of hardware and software development and/or customization, cost of system maintenance, and comparison of net clinician time for encounter documentation relative to a paper-based standard. Feasibility, acceptance, and cost-effectiveness were established.

Decision Making, Computer-Assisted↗
PubMed1995

CLECOS_P: clinical evolution control system on Parkinsonian patients undergoing neural transplantation.

The CLECOS_P system was conceived for registering and automating the processing of clinical evaluations performed on patients with Parkinson's disease who undergo functional neurosurgery and/or neural transplant. CLECOS_P represents the first time a computerized system is able to offer--with high precision and considerable time-savings--an integral analysis of the evolutive behavior of the universe in integrated variables at the core assessment program for intracerebral transplantations (CAPIT). CAPIT is used internationally for the evaluation and follow-up of patients with this pathology who have undergone neural transplant. We used the so-called MEDSAC methodology for the preparation of this system. The methodology that was used for the design of an intelligent system aimed at medical decision-making was based on the quantitative analysis of the clinical evolution. At the present moment, there are 20 patients controlled by this system: 11 bilaterally transplanted, 9 unilaterally (registered in ranks of 3 months before operation up to 1, 2, 3, 6, 9, 12, 18, and 24 months after operation). The application of CLECOS_P to these patients permitted the evaluation of 400 clinical variables, where a better evolutive characterization of the patients was obtained, thus getting most favorable results with personalized therapeutic methods aimed at raising their quality of life. CLECOS_P is used in a multi-user environment on a local area network running Novell Netware version 3.11.

Brain Tissue Transplantation↗
PubMed1995

4.5 years of experience with an electronic patient record system at the University of Munich: PADS (Patient Archiving & Documentation System).

We demonstrate an Ethernet based local area network (LAN) with clinical workstations (Apple Macintosh). The patient archiving and documentation system (PADS) represents a computerized patient record system presently used in a university hospital's ICU, CCU, and oncology unit [1]. Since 1990, over 100 users have documented more than 6,000 patient admissions, equaling 30% of all inpatient admission in our hospital. Taking full advantage of the macintosh based graphical user interface (GUI), our system enables nurses and doctors to perform the following tasks: admission, medical history taking, physical examination, generation of problem lists and follow up notes, access to laboratory data and reports, and the semiautomatic generation of a discharge summary including full word processor capabilities. Furthermore, the system offers rapid, consistent, and complete automatic encoding of diagnoses following the International Classification of Disease (ICD - 9 CM; WHO). The system has links to other educational programs such as cardiac auscultation and image analysis. A MEDLINE literature search through a CD-ROM based system can be performed from within the system. CD-ROM based medical textbooks can be accessed as well. Users can customize their working environment and use any commercially available macintosh programs from within the main application. Additional options include: automatic background monitoring of users learning behavior, analyses and graphical display of numerous epidemiological, and healthcare related problems. Furthermore, sound and digital video can be recorded in our system. E had initially developed a relational database 4GL development tool in the rapid prototyping phase, and have since completed the next step of development: rewriting the complete application using C++ and Oracle. The user interface has hardly changed, maintaining the "look & feel" of the initial application and introducing the performance of a professional relational database management system (RDBMS). This system represents one in a line of modular departmental models which are being integrated to form a decentralized hospital information system (HIS) at the University of Munich. The proposed theater-style demonstration will walk the audience through the system simulating a true patient admission and work up.

Germany↗
PubMed1995

A new and cheap medical examination system with artificial intelligence.

This is a medical examination system with artificial intelligence. It is used to find persons who want to obtain higher professional posts in the medical field, including doctors, dentists, nurses, pharmaceutists, etc. It has a question bank of 536,000 multiple choice questions (MCQs), of which 59,500 have pictures. Ten percent of the MCQs is updated every year; the old MCQs in the question bank are used as exercises for the persons who want to obtain higher professional posts. The system, with three distinctive degrees of difficulty, is applicable to three different professional posts: the assistant physician, the resident, and the attending physician. It ensures the general level of assessment for the same professional post, regardless of when one wants to take the system. In addition, the system also guarantees the consistency of the following three factors: the constituent of sub-professions, the classification of MCQs, and the degree of difficulty of each MCQ. Another feature of the system is that the passing score need not be the traditional standard passing score of 60. The passing score is determined by the system according to the requirements of the different professional posts and the degree of difficulty of the MCQs in the system. Therefore, the new method for passing the system is more rational than the traditional one. Moreover, the final score given by the system will be standardized to eliminate sampling errors. The reliability of the system will also be tested after each examination. If the coefficient of reliability is lower than 0.85, the scores will be canceled and examination will be repeated. The system can accept 96 persons simultaneously taking the examination with on-line computers. The people who work in remote places can take examination in their hospital with a personal computer linked via telephone. The system has already been approved by the relevant authoritative departments in China. It has been running successfully for more than six years. During this period of time, 125,645 candidates have taken the exam; 64,078 have passed the examination and have been promoted to higher professional posts. The system runs on local area network and uses a program written in PROLOG and FoxPro. It is estimated that the total cost of developing the system is less than $46,000 (US).

Artificial Intelligence↗
PubMed1995

[Cardiologic application of a clinical database with graphic extension and its utilization in inter-hospital teleconsultation].

A local area network of personal computers has been operative in our Cardiology Department for seven years, to collect and retrieve on-line character-based data. At present, the network is based on 2 servers and 21 workstations. DBF and DOS files are used by a Clipper 5.2d compiled program to handle demographic data, clinical reports (32,000/year) and diagnostic codes of more than 52,000 patients. In the last two years, we started entring ECG tracings using: RS232 connection, floppy disk transfer, and modem connection with commercially available machines as well as by image scanner. We integrated our clinical database with three dedicated subsystems, written in Assembly and C languages, to manage drawings, digital ECGs and complete reports. Mass storage is provided by a 10 Gbyte magneto-optical disk autochanger physically connected to a dedicated server running an original software manager to optimize routine access to the optical disks. Interhospital network connections were established with two different institutions to allow clinical information sharing, long distance consultation and ECG transfer. The system has been found to be fast, user-friendly and suitable for daily operation of a large cardiological database. Standardized versions of the system are running in seven other cardiology institutions in Italy.

Cardiology↗
PubMedDate not supplied

[A computer system for the systematization of MR findings in knee joint diseases].

An inexpensive, easy-access computer-based system is proposed, which was developed for the systematization of the clinical series of knee joint disorders studied with Magnetic Resonance Imaging (MRI). The system is based upon the integration of multimedia technology and Data Base Management Systems (DBMS). The hardware configuration for this project included an Apple Macintosh workstation based on a Motorola 68040 microprocessor and a customized application developed by the authors with the 4th Dimension software. The MR images available only on film were digitized off-line with a solid-state Charge Coupled Device (CCD) scanner with back-light cover for transparency. Otherwise, MR images were acquired on-line through an Ethernet-based local area network from the MR unit or from a SparcStation-Advantage Windows workstation connected with the MR unit. Image post-processing was performed with the Adobe PhotoShop software. The system was devoted to the systematization and analysis of a clinical series of 800 MR studies of the knee. A mean of 10 significant MR images were stored for each examination with a standard image compression algorithm--the Joint Photographic Experts Group (JPEG). This permitted us to save the system's storage space and at the same time to preserve image quality for consultation and teaching purposes, not for diagnosis which is made on the backboard or on the MR unit's or Advantage Window's monitor. Finally, MR findings were indexed with a customized check-list specific for knee joint disorders. On the basis of stored and selected information, it was thus possible to carry out a statistical analysis and to make detailed reports which are useful for scientific purposes, such as the preparation of lectures and papers. Moreover, the system was very useful for patients' follow-up and for the preparation of hypermedia teaching applications on knee joint disorders which are available on the Internet at our World-Wide Web server (URL: http://mbox.unipa.it/radpa/radpa ++ +.html). In conclusion, the system is a cost-effective and user-friendly solution for the multipurpose management of radiologic series.

Humans↗
PubMed1996

[An international exchange and dissemination of chemical safety information on the Internet].

An information system for chemical safety has been developed on the National Institute of Health Sciences (NIHS) Information and Computing Infrastructure. The system is based on client server systems on the local area network (LAN) connected to the Internet. A wide range of safety information for chemicals including foods, food additives, household goods, industrial chemicals and environmental pollutants were collected and put on the World Wide Web (WWW) server and the database management system, Sybase. In addition to original information contents, the System has links to many useful Web sites so that it functions as a global hub for chemical safety information.

Agrochemicals↗
PubMed1997

[Medical practice-supporting system in pulmonary function testing].

A pulmonary function testing system which automates measurement, storage and reporting as much possible has been functioning in Mitsui Memorial Hospital since 1992. Data obtained from four measurement apparatus are transferred to the central microcomputer by a local area network (LAN). To facilitate automatic interpretation, we developed a knowledge-based system using 87 production rules called 'PADRES', because the knowledge-based system had the following advantages over other systems; (1) The expression of knowledge is understandable and new pieces of knowledge can be easily added, (2) the process of reasoning can be clearly shown, and (3) the accumulation of many instances of data is not required. Using 'PADRES', it takes 2.6 seconds to interpret one set of data on average. Our system performs about 5,000 routine pulmonary function tests per year without faults. Because the program for interpretation is a separate module written in C language, it is readily portable to other operating systems (OS), although its original target was OS-9, a multitask operating system for microcomputers. In conclusion, the application of a knowledge-based system for microcomputers in the pulmonary function test laboratory was considered successful.

Electronic Data Processing↗
PubMed1997

[Construction of an MRI reporting system using the Internet].

Out university hospital, includes a LAN (Local Area Network) and uses network services such as WWW(World Wide Web). We have constructed an MRI diagnostic reporting system on the Internet in which interactive date management was established on WWW by using CGI (Common Gateway Interface) software. Linking database information such as MRI reports with WWW browsers using by CGI provides easy data access to the database and offers hypertext and searching. This system suggests the possibility of creating a cheaper and more flexible network using Internet technology.

Computer Communication Networks↗
PubMedDate not supplied

Implementing instructional technology. Strategies for success.

This article describes strategies for the integration of computer technology in a university-based school of nursing. Faculty concerns related to use of computer technology were assessed in a previous study. A series of computer technology and literacy workshops were developed based on this assessment. Computer use increased and faculty concerns about technology decreased after workshop participation. Other strategies to integrate computer technology include developing an informatics committee and planning and initiating a technology infrastructure consisting of hardware and software resources, and a local area network. Strategic planning was initiated placing increasing emphasis on curriculum integration of computer technology and nursing informatics.

Attitude to Computers↗
PubMedDate not supplied

[Evaluation of a registration card for logging electrocardiographic records into standard personal computers].

BACKGROUND: The MS200 Cardioscope, from MRT Micro as., Norway, is a 12 channel ECG card to be directly inserted into a standard personal computer (PC). The standard ISA Bus compatible half length card comes with a set of 10 cables with electrodes and the software for recording, displaying and saving ECG signals. The system is supplied with DOS or Windows software. The goal of the present work was to evaluate the affordability and usability of the MS200 in a clinical setting. MATERIALS AND METHODS: We tested the 1.5 DOS version of the software. In 30 patients with various cardiac diseases the ECG signal has been recorded with MS200 and with standard Hellige CardioSmart equipment. The saved ECGs were recalled and printed using an Epson Stylus 800 ink-jet printer. Two cardiologists reviewed the recordings for a looking at output quality, amplitude and speed precision, artifacts, etc. RESULTS: 1) Installation: the card has proven to be totally compatible with the hardware; no changes in default settings had to be made. 2) Usage: the screens are clear; the commands and menus are intuitive and easy to use. Due to the boot-strap and software loading procedures and, most important, off-line printing, the time needed to obtain a complete ECG printout has been longer than that of the reference machine. 3) Archiving and retrieval of ECG: the ECG curves can be saved in original or compressed form: selecting the latter, the noise and non-ECG information is filtered away and the space consumption on disk is reduced: on average, 20 Kb are needed for 10 seconds of signal. The MS200 can be run on a Local Area Network and is prepared for integrating with an existing informative system: we are currently testing the system in this scenery. 4) MS200 includes options for on-line diagnosis, a technology we have not tested in the present work. 5) The only setting allowed for printing full pages is letter size (A4): the quality of printouts is good, with a resolution of 180 DPI. CONCLUSIONS: In conclusion, the MS200 system seems reliable and safe. In the configuration we tested, it cannot substitute a dedicated ECG equipment: from this point of view, a smaller PCMCIA-type card with a battery-operated notebook PC will be more suitable for clinical uses. Nevertheless, the possibility to log and track ECG records, integrated into the department informative system, may provide a valuable tool for improving access to medical information.

Electrocardiography↗
PubMed1998

[Report management system using Web server and search engine].

PURPOSE: To develop a management system of written reports using a Web server and search engine. METHODS: All the reports written through word processing software in the local area network in the radiology department were automatically transferred to one of the PC servers, in which a Web server and search engine were in operation. Previous reports, approximately eighty thousand, were also registered. Using Web browsers and the program developed by hypertext mark-up language and JavaScript, all the reports were readily accessible by keywords, or by any words within reports. RESULTS: Over 100, 000 reports were easily accessible using Web browsers, based on our one-year experience. Maintaining the Web server and search engine, and upgrading the program were easily managed in our daily practice. CONCLUSION: The report management system we developed is flexible, scalable, and easy to maintain. It is an effective way to manage a large volume of radiology reports written through word processing software.

Computer Communication Networks↗
PubMed1998

[Suicidal impulses in patients with chronic viral hepatitis C during or after therapy with interferon alpha].

UNLABELLED: We report 5 cases of psychiatric side effects in patients treated with alpha interferon for chronic viral C hepatitis. The first case includes depression with suicidal impulses without a suicide attempt; there was a positive rechallenge of interferon. In the second and third cases, depression occurred during interferon therapy, but has not disappeared after interferon withdrawal. In the 4th and 5th cases, depression occurred after interferon withdrawal. Overall, suicide was attempted in 4 cases after interferon withdrawal and was responsible for 2 deaths. The prevalence of suicide attempts during the 6 to 12 months of interferon therapy was 0% compared to 1.3% during the 6 months after interferon therapy (P < 0.05) in 306 patients with chronic hepatitis C treated by interferon in our local area network during the same period. IN CONCLUSION: a) depression does not always disappear after interferon is discontinued; b) regular psychiatric follow-up is justified during treatment with interferon; c) psychiatric supervision should be continued, even more frequently after interferon withdrawal; d) the increased risk of psychiatric side-effect due to interferon as well as their severity suggest interferon should be administered with caution; e) the role of interferon can only be evaluated in controlled studies including the incidence and predictive value of emotional disorders.

Adult↗