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At least 397 records · Page 22Linked to original sources

Mechanisms for exchange of image data to support distant medical consultation.

The VA has developed an integrated infrastructure to support the exchange of medical data, including images and text report data, between medical centers. This capability is expected to support teleconsulting and meet a variety of existing medical staffing and consultation needs. Consultation from distant locations requires at least the same complete integrated patient record available to onsite physicians. Several mechanisms are being explored to support distant medical consultation. Multimedia extensions to the VA's electronic mail system have been developed to allow images and other data objects to be included in electronic mail messages. Another approach that has been prototyped is to extend existing local imaging networks to produce more widely distributed imaging systems. These approaches will be described and discussed.

Computer Communication Networks↗

Lightweight, mobile E-mail for intra-clinic communication.

We have developed a mobile messaging system designed for use in the clinic setting. The system is designed to facilitate quick, informal, interactions that occur in a clinical setting, e.g., requests for assistance or information. The system includes safeguards to make sure that the sender of a message is aware if a message is not read in a timely fashion. Evaluation of the system shows message delivery was about 50% slower than our target of 30 seconds. Although the mobile device used is fairly small when combined with a radio unit, it is too bulky and users did not necessarily carry the system with them. This led to delays (over eleven minutes on average) before messages were seen. We expect that improvements in hardware and clinical software will lead to more common use of such adjunct software systems.

Communication↗

Internet-based support for bioscience research: a collaborative genome center for human chromosome 12.

This paper describes an approach that provides Internet-based support for a genome center to map human chromosome 12, as a collaboration between laboratories at the Albert Einstein College of Medicine in Bronx, New York, and the Yale University School of Medicine in New Haven, Connecticut. Informatics is well established as an important enabling technology within the genome mapping community. The goal of this paper is to use the chromosome 12 project as a case study to introduce a medical informatics audience to certain issues involved in genome informatics and in the Internet-based support of collaborative bioscience research. Central to the approach described is a shared database (DB/12) with Macintosh clients in the participating laboratories running the 4th Dimension database program as a user-friendly front end, and a Sun SPARCstation-2 server running Sybase. The central component of the database stores information about yeast artificial chromosomes (YACs), each containing a segment of human DNA from chromosome 12 to which genome markers have been mapped, such that an overlapping set of YACs (called a "contig") can be identified, along with an ordering of the markers. The approach also includes 1) a map assembly tool developed to help biologists interpret their data, proposing a ranked set of candidate maps, 2) the integration of DB/12 with external databases and tools, and 3) the dissemination of the results. This paper discusses several of the lessons learned that apply to many other areas of bioscience, and the potential role for the field of medical informatics in helping to provide such support.

Chromosome Mapping↗

Wireless and PDA: a novel strategy to access DICOM-compliant medical data on mobile devices.

The medical procedures at the patient bedside are out of the scope of current HIS/RIS systems, which means that patient record and image data access during the medical visit or the execution, recording and confirmation of the medicine prescriptions, still do not enjoy computerized support. As a consequence, the necessary inclusion of new data to the patient record, still needs to be carried out through notations on paper and later typed, causes delays on the availability of this information (Mobile computing in a hospital: the Ward-In-Hand project. SAC 2000-ACM Symposium on Applied Computing, Março, 2000, Villa Olmo, Como, Italy). This paper presents a software technology where the medical and nursing staff will be equipped with a handheld computer connected by radio to a central server that provides access to the electronic patient records and that will actively inform about tasks pending distribution. The server acts as a database for multimodal electronic patient record information, storing patient data from computerized tomography (CT), ultrasonography (US), magnetic resonance (MRI) images and also medical findings, observations and prescriptions coded as DICOM Structured Reports (Digital Image and Communications in Medicine). The prototype described in this article implements a medical images and structured reports server that makes the search and recovery of data stored in the DICOM standard possible.

Brazil↗

ARIANE: integration of information databases within a hospital intranet.

Large information systems handle massive volume of data stored in heterogeneous sources. Each server has its own model of representation of concepts with regard to its aims. One of the main problems end-users encounter when accessing different servers is to match their own viewpoint on biomedical concepts with the various representations that are made in the databases servers. The aim of the project ARIANE is to provide end-users with easy-to-use and natural means to access and query heterogeneous information databases. The objectives of this research work consist in building a conceptual interface by means of the Internet technology inside an enterprise Intranet and to propose a method to realize it. This method is based on the knowledge sources provided by the Unified Medical Language System (UMLS) project of the US National Library of Medicine. Experiments concern queries to three different information servers: PubMed, a Medline server of the NLM; Thériaque, a French database on drugs implemented in the Hospital Intranet; and a Web site dedicated to Internet resources in gastroenterology and nutrition, located at the Faculty of Medicine of Nice (France). Accessing to each of these servers is different according to the kind of information delivered and according to the technology used to query it. Dealing with health care professional workstation, the authors introduced in the ARIANE project quality criteria in order to attempt a homogeneous and efficient way to build a query system able to be integrated in existing information systems and to integrate existing and new information sources.

Computer Communication Networks↗

Live on the Internet: surgery.

A Massachusetts hospital uses live surgical scenes, an interactive survey and other measures to build interest in its Web site. It's also using Internet technology for its growing intranet.

Commerce↗

A hospital-wide distributed PACS based on intranet.

A hospital-wide Picture Archiving and Communication System (PACS) is currently under development at the University Hospital of Geneva. After a first implementation including two oneterabyte optical libraries, the system is expanded to integrate all the imaging modalities of the hospital. The new storage requirement is 10 terabytes to cover three year archive. A large distributed image archive has been designed including new archive servers for long-term storage and display servers for medium-term storage. The acquisition, archive and distribution cycles are performed using separated networks combining Fast Ethernet and Ethernet. Image files are distributed to the wide-hospital using a prefetching strategy or an Intranet server, RADIOLAB. The first mode takes advantage of the fully integrated hospital information system DIOGENE 2 to allow the automatic retrieval of studies in advance. The second mode provides a convivial study selection from any conventional WWW (World Wide Web) browser. Image files are then transmitted to the user's display station using HTTP (HyperText Transfer Protocol) and handled by OSIRIS software, which acts as a helper or viewer. Such a system is expected to meet the time requirement, which is less than three seconds per image.

Computer Communication Networks↗

The Internet: will this highway serve the digital library?

The future of the biomedical enterprise and the biomedical libraries that serve it is tied closely to digital information. The changing nature of this type of information will create new pressures on libraries, particularly in health care organizations. Libraries must learn to deal with these pressures. Currently, libraries depend on the Internet primarily for connections to resources and other libraries; thus enhancements to the Internet will impact the libraries of the present and future significantly. This paper provides an overview of the technical capabilities that will be available in the near to midterm, what libraries will be able to do with those capabilities, and how libraries can position themselves to take advantage of the impending changes.

Computer Communication Networks↗

Clinical communication among health providers and systems using Web tools.

Three needs have driven the development of a Web front end to our legacy system. 1) A Web Intranet is needed to provide service for the quantity and diversity of platforms within our health care system. 2) Information transfer in our system is required in more than one format: in viewer-friendly, HTML format and in a database-friendly, down-loadable format. 3) The system encounters the need to electronically exchange information with providers that are not employees of our health care enterprise. This presents a problem with the authentication aspect of security for which we have devised a system to allow the carefully-monitored exchange of records with care providers who are "strangers" to our system.

Communication↗

A programme management model for the Nova Scotia telemedicine network.

Sustainable telemedicine networks are not the norm but rather the exception. Unless a formal programme management model is in place, telemedicine cannot be integrated successfully into the mainstream of modern health care. Critical factors in achieving sustainable telemedicine have been identified. The programme management model developed for the Nova Scotia Telemedicine Network incorporated the following tools: a telemedicine self-assessment indicator, service modelling, technical design and integration, application development and validation, scheduling, ongoing network management and evaluation.

Delivery of Health Care↗

Multilevel lab networks: PC-mini blend with a twist.

Today's clinical laboratory is a partially automated, transaction-intensive environment. The advent of what Dr. Perry Seamonds calls "multilevel" networks puts sophisticated, efficient processing within reach of laboratories that may have been relying on less powerful networking systems.

Clinical Laboratory Information Systems↗