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SHINE: Strategic Health Informatics Networks for Europe.

The mission of SHINE is to construct an open systems framework for the development of regional community healthcare telematic services that support and add to the strategic business objectives of European healthcare providers and purchasers. This framework will contain a Methodology, that identifies healthcare business processes and develops a supporting IT strategy, and the Open Health Environment. This consists of an architecture and information standards that are 'open' and will be available to any organisation wishing to construct SHINE conform regional healthcare telematic services. Results are: generic models, e.g., regional healthcare business networks, IT strategies; demonstrable, e.g., pilot demonstrators, application and service prototypes; reports, e.g., SHINE Methodology, pilot specifications & evaluations; proposals, e.g., service/interface specifications, standards conformance.

Community Health Planning↗

STRUCTURELAB: a heterogeneous bioinformatics system for RNA structure analysis.

STRUCTURELAB is a computational system that has been developed to permit the use of a broad array of approaches for the analysis of the structure of RNA. The goal of the development is to provide a large set of tools that can be well integrated with experimental biology to aid in the process of the determination of the underlying structure of RNA sequences. The approach taken views the structure determination problem as one of dealing with a database of many computationally generated structures and provides the capability to analyze this data set from different perspectives. Many algorithms are integrated into one system that also utilizes a heterogeneous computing approach permitting the use of several computer architectures to help solve the posed problems. These different computational platforms make it relatively easy to incorporate currently existing programs as well as newly developed algorithms and to best match these algorithms to the appropriate hardware. The system has been written in Common Lisp running on SUN or SGI Unix workstations, and it utilizes a network of participating machines defined in reconfigurable tables. A window-based interface makes this heterogeneous environment as transparent to the user as possible.

Algorithms↗

An open distributed medical image and signal data server network with World Wide Web front-end.

In modern patient care and medical research diagnostic imaging from multiple modalities plays an essential role. In general these digital image data are acquired at different locations. An efficient access to the data via network is often not provided due to technical, organisational and political reasons. This article presents an approach to solve the problem by means of an open distributed data server network with Web-based front-ends and describes the prototype DACHS that has been developed at the University Hospital of the Technical University of Munich.

Computer Communication Networks↗

Best face forward.

Most companies serve customers through a broad array of interfaces, from retail sales clerks to Web sites to voice-response telephone systems. But while the typical company has an impressive interface collection, it doesn't have an interface system. That is, the whole set does not add up to the sum of its parts in its ability to provide service and build customer relationships. Too many people and too many machines operating with insufficient coordination (and often at cross-purposes) mean rising complexity, costs, and customer dissatisfaction. In a world where companies compete not on what they sell but on how they sell it, turning that liability into an asset is what separates winners from losers. In this adaptation of their forthcoming book by the same title, Jeffrey Rayport and Bernard Jaworski explain how companies must reengineer their customer interface systems for optimal efficiency and effectiveness. Part of that transformation, they observe, will involve a steady encroachment by machine interfaces into areas that have long been the sacred province of humans. Managers now have opportunities unprecedented in the history of business to use machines, not just people, to credibly manage their interactions with customers. Because people and machines each have their strengths and weaknesses, company executives must identify what people do best, what machines do best, and how to deploy them separately and together. Front-office reengineering subjects every current and potential service interface to an analysis of opportunities for substitution (using machines instead of people), complementarity (using a mix of machines and people), and displacement (using networks to shift physical locations of people and machines), with the twin objectives of compressing costs and driving top-line growth through increased customer value.

Commerce↗

A multimedia medical communication link between a radiology department and an emergency department.

The most critical aspect of a radiologist's work is communicating his findings to the attending physician responsible for the patient's care. This is also the part of the process that is least well organized and the most subject to failure. At the University of Ottawa Medical Communications Research Centre we are investigating technical means to improving communications between radiologists and attending physicians. We first introduce the radiology communication service problem and show why it is essentially a multimedia communication problem. We then briefly describe a multimedia communication system designed and implemented by our research team. The multimedia system consists of several work stations linked by the Hospital's local area network (LAN). Each physician work station comprises a Compaq 386/20-Mhz microcomputer with 16 Mbytes of RAM, a 500-Mbyte image disk, and an image memory that drives a 1,000-line monochrome monitor. The images are digitized using a Konica laser-based film digitizer (2430 by 2000 10-bit pixels for a standard chest radiograph). The multimedia file server manager station is built around a PC-AT compatible with a Northern Telecom Meridian SL-1ST digital PBX and a Meridian Mail digital voice messaging system. This last device is used to store voice data and is linked via the PBX to the workstations' digital telephones. A Sytek 6,000 LAN links all work stations to the file server. All data, image, and graphic information is transmitted via this network, while the twisted pair connections linking the digital PBX to the telephone sets are used for transmitting voice data.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗

[Computers in general practice of the established gynecologist: market status--electronic data processing solutions--electronic data processing problems--future perspectives].

Since the end of the seventies a great change of edp-use in gynecological private practice took place. Many applications (for example ICD-coding) are not feasible in short time. In medicine, the electronic data processing is not as practicable as the technical progress permits. In only a few programs we can find gynecological specific electronic data processing solutions, networks between private practices, hospitals and Internet access. It is necessary to claim edp-solutions for gynecological private practice and define standards for programming electronic data processing in medicine.

Computer Communication Networks↗

Communication technologies in health care environments.

A successful implementation of hierarchical health care networks is dependent on a number of different technical and non technical factors. This paper investigates how the networking technologies, both 'traditional' and broadband, can support the communication requirements of medical environments. The general purpose is to implement communication infrastructures and services, which will improve the collaboration between the different partners in the health sector in offering better healthcare services at affordable costs.

Computer Communication Networks↗

Gross anatomy of network security.

Information security involves many branches of effort, including information assurance, host level security, physical security, and network security. Computer network security methods and implementations are given a top-down description to permit a medically focused audience to anchor this information to their daily practice. The depth of detail of network functionality and security measures, like that of the study of human anatomy, can be highly involved. Presented at the level of major gross anatomical systems, this paper will focus on network backbone implementation and perimeter defenses, then diagnostic tools, and finally the user practices (the human element). Physical security measures, though significant, have been defined as beyond the scope of this presentation.

Computer Communication Networks↗

A distributed simulation technique for multiple input multiple output systems.

Distributed computing concepts have been attempted in the realm of real-time process control for a long time. This started with the systolic arrays of processors and an enormous amount of research has been done in this field. This paper proposes a methodology by which a multiple input multiple output system representing a plant and defined in terms of connected blocks of transfer functions can be decomposed into a set of parallel simulation processes in a message passing environment viz. a network of work stations. The paper also analyzes the scope of optimization of the processing time associated with each task. The methodology includes online reconfiguration of the system.

Algorithms↗

The Rapid Syndrome Validation Project (RSVP).

The Rapid Syndrome Validation Project (RSVP) is a collaboration of several institutions: Sandia and Los Alamos National Laboratories, the University of New Mexico Department of Emergency Medicine, and the NM Department of Health Office of Epidemiology. RSVP is a system that operates at the intersection of individual health care providers, public health and bioterrorism. Physicians quickly enter clinical and demographic information on patients exhibiting symptoms and signs of the syndromes of interest. It provides early warning and response to emerging biological threats, as well as emerging epidemics and diseases. RSVP provides real time clinical information to the provider and any other potential user such as the DOH, about current symptoms, disease prevalence and location. The system also serves as a mechanism for the Department of Health to inform health care providers of health alerts and to facilitate the process of collecting data on reportable diseases. We describe here the purpose an the architecture of a network-based surveillance system that is currently implemented in an Emergency Department.

Bioterrorism↗

Information for trained nurses in remote areas: do electronically networked resources provide an answer?

This paper reports on a research project which examined the potential of the Internet, and other networked information resources, to improve access to information for trained nurses working in remote areas. This paper provides a review of current literature in the field. It describes the research carried out, presents a summary of the research findings and discusses the implications of these findings. The paper concludes that the Internet and networked resources do have considerable potential to improve access to information for nurses working in remote and rural areas. However, information skills, along with professional guidance, are also required.

Community Health Services↗

Heuristic walkthrough evaluation of a prototype computer network service for occupational therapists.

AIM: To identify utility and design criteria for a computer network service for occupational therapists. DESIGN: Heuristic walkthrough evaluation. The evaluators explored a prototype and then commented upon the design in plenary sessions. SUBJECTS: One group of information system design experts and one of occupational therapists. RESULTS: The central utility criteria were the possibility to organize dynamic work groups for development of the occupational therapy profession and access to databases on assistive technologies. The main system design criteria identified were navigation, structure, tools, and content. CONCLUSION: A computer network service can support the development of the therapy professions. Generic issues exist which need to be considered in the detailed design. The heuristic walkthrough method is useful for identifying these.

Computer Communication Networks↗

[A telemedical multilevel server network system].

Telemedicine is a hot research focus. When we develop the telemedicine system, we find that in China the network condition can not fit the demands of the transregional telemedicine service. In order to improve the poor conditions, we have designed a set of telemedicine system based on distributed multilevel server network model. The paper expounds the structure and the working process of the system, then goes into the technology details in realizing it, finally discusses some relative questions.

Computer Communication Networks↗

Understanding and using DICOM, the data interchange standard for biomedical imaging.

The Digital Imaging and Communications in Medicine (DICOM) Standard specifies a non-proprietary data interchange protocol, digital image format, and file structure for biomedical images and image-related information. The fundamental concepts of the DICOM message protocol, services, and information objects are reviewed as background for a detailed discussion of the functionality of DICOM; the innovations and limitations of the Standard; and the impact of various DICOM features on information system users. DICOM addresses five general application areas: (1) network image management, (2) network image interpretation management, (3) network print management, (4) imaging procedure management, (5) off-line storage media management. DICOM is a complete specification of the elements required to achieve a practical level of automatic interoperability between biomedical imaging computer systems--from application layer to bit-stream encoding. The Standard is being extended and expanded in modular fashion to support new applications and incorporate new technology. An interface to other Information Systems provides for shared management of patient, procedure, and results information related to images. A Conformance Statement template enables a knowledgeable user to determine if interoperability between two implementations is possible. Knowledge of DICOM's benefits and realistic understanding of its limitations enable one to use the Standard effectively as the basis for a long term implementation strategy for image management and communications systems.

Computer Communication Networks↗

Osprey: a network visualization system.

We have developed a software platform called Osprey for visualization and manipulation of complex interaction networks. Osprey builds data-rich graphical representations that are color-coded for gene function and experimental interaction data. Mouse-over functions allow rapid elaboration and organization of network diagrams in a spoke model format. User-defined large-scale data sets can be readily combined with Osprey for comparison of different methods.

Computational Biology↗

Implementation of a province-wide computerized network in Quebec: the FAMUS Project.

General practitioners have busy schedules and are accustomed to working autonomously. But they will take an interest in research issues that could increase their efficiency or improve patient care. The use of medical informatics tools to facilitate collaborative research networks requires that participants accept the tools. This article describes the implementation of a province-wide computing network and discusses the opportunities afforded by the creation of a large central database documenting the process of care.

Ambulatory Care Information Systems↗

The transition to digital media in biocommunications.

As digital audiovisual media become dominant in biomedical communications, the skills of human interface design and the technology of client-server multimedia data networks will underlie and influence virtually every aspect of biocommunications professional practice. The transition to digital communications media will require financial, organizational, and professional changes in current biomedical communications departments, and will require a multi-disciplinary approach that will blur the boundaries of the current biocommunications professions.

Computer Communication Networks↗

Data exchange in the European pharmacovigilance.

Recent research work on feasible solutions for electronic data exchanges in the european pharmacovigilance domain (EPhV) has facilitated a better understanding on strategic and operational factors inherent to such a class of transnational vigilance information systems. Most of the material presented here has resulted from the CARE-Pharmacovigilance Pilot project of the ENS-Telematics Programme, and from other subsequent research activities like the IDA feasibility study and the TEDIS-EuroSCape project. Attention has been paid to design principles and features of a communication scheme that must be used to support cooperative problem solving within a network of loosely connected autonomous and hetereogeneous agents. Experience confirmed two key-success factors: a) the users leading role, and b) the Pilot approach putting the focus on standardized electronic data interchange for communicating existing different local systems.

Adverse Drug Reaction Reporting Systems↗