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At least 433 records · Page 24Linked to original sources
PubMed1999

The dissemination of clinical practice guidelines over an intranet: an evaluation.

This study compares two clinical practice guideline dissemination systems. It was hypothesized that placing guidelines on an intranet would make this information easier to retrieve. Retrieval time, retrieval accuracy, and ease of use were empirically evaluated. Sixteen clinicians from Kaiser Permanente volunteered to complete tasks that measured these variables. Time values were significantly longer for tasks completed with intranet guidelines (Intranet = 6.7 minutes, Paper = 5.7 minutes). Tasks completed with paper guidelines had a significantly higher percentage of perfect scores than those completed with the intranet (Paper = 85%, Intranet = 59%). There was no significant difference in reported ease of use. Simply placing clinical information on an electronic system does not guarantee that the information will be easier to retrieve. Such information needs to be fully integrated into the clinical decision making process. Computerizing guidelines may provide a necessary initial step toward this goal, but it does not represent the final solution.

Adult↗
PubMed1994

The technical conditions for an open architecture.

The development of Open Systems Architecture and the extensive networked interconnection of Health and Hospital Information Systems (HIS) offer great opportunities for improved care, but simultaneously these facilities pose a great danger to the overall security of the information held. The Geneva University Hospital which has built up it centralized informatics system over the last twenty years must now bring about the conditions for a migration towards open system, for although during the last ten years there have been declarations of intent, this architecture is still a long way from final implementation. Like others, the DIOGENE system (the Geneva HIS) has had to face difficult choices especially due to its own successful situation at the end of the eighties. This paper gives a brief explanation of the technical conditions needed in order to fully migrate towards an open system. The first choices towards obtaining optimum communication standards, operating systems and database management systems were the easiest. The real difficulties occurred when deciding on the choice for management tools in this open environment.

Computer Communication Networks↗
PubMed1998

Automated routing of DICOM CT, MR, and CR images: solving the pitfalls of vendor-specific DICOM implementations.

This paper details our experience in developing and implementing an automated DICOM Image Router. This workstation serves as a gateway between image acquisition devices and image display and storage devices. Images are checked for demographic input errors and data format inconsistencies between the source and destination devices. Based on the configured rules, and image may be held for manual correction and/or distributed to multiple locations. Distribution is based on easily configured environmental variables and rules files which may be changed as needed. For example, CT images are typically sent to the archive and to a radiologist's display workstation. If the patient came from the Emergency Department, a copy of the images are sent to a clinician display workstation located in the Emergency Department. If the patient has suffered trauma to the head, a copy of the images are sent to a display workstation in the Neurosurgery Department for possible consultation. The software was developed on a UNIX-based platform and utilizes a Fast Ethernet network. To date, images from a variety of devices have been acquired: General Electric HiSpeed CT/I scanner, General Electric Signa MRI scanner, Philips Thoravision Digital Chest unit, and Fuji AC-3CS Computed Radiography (CR) unit. Each device has presented new challenges in providing a uniform look to patient demographics in the PACS archive. The workstation also provides a buffer in the event of network outages, storing images for later transmission when the network and/or a workstation recover.

Diagnostic Imaging↗
PubMed2000

Realization of security concepts for DICOM-based distributed medical services.

Exploiting distributed hard- and software resources for telemedicine requires a fast, secure, and platform-independent data exchange. Standards without inherent security mechanisms such as DICOM may ease non-authorized data access. Therefore, exemplary telemedical data streams were analyzed within the Berlin metropolitan area network using specialized magnetic resonance imaging techniques and distributed resources for data postprocessing. For secure DICOM communication both the Secure Socket Layer Protocol and a DICOM-conform partial encryption of patient-relevant data were implemented. Partial encryption exhibited the highest transfer rate and enabled a secure long-term storage. Different data streams between secured and unsecured networks were realized using partial encryption.

Berlin↗
PubMedDate not supplied

Workflow in nuclear medicine.

This paper discusses a workflow management system for nuclear medicine. It augments the more conventional PACS with automatic transfer of studies along the chain of activities making up an examination in nuclear medicine. A prototype system has been designed, built, and installed in a department of nuclear medicine, active in a network of hospitals.

Belgium↗
PubMed2002

Saying goodbye to optical storage technology.

The days of using optical disk based mass storage devices for high volume applications like health care document imaging are coming to an end. The price/performance curve for redundant magnetic disks, known as RAID, is now more positive than for optical disks. All types of application systems, across many sectors of the marketplace are using these newer magnetic technologies, including insurance, banking, aerospace, as well as health care. The main components of these new storage technologies are RAID and SAN. SAN refers to storage area network, which is a complex mechanism of switches and connections that allow multiple systems to store huge amounts of data securely and safely.

Computer Storage Devices↗
PubMed1986

Overview of an architectural approach to the development of the Johns Hopkins Hospital distributed clinical information system.

The Johns Hopkins Hospital has initiated an ambitious program to apply modern technologies to the development of a new, comprehensive clinical information system. Since many components of a system exist and since the JHH management is decentralized, a distributed, networked system is being built. To properly accomplish this task an architectural basis for strategic systems planning was developed. This paper reviews briefly the layered architectural approach.

Computer Communication Networks↗
PubMed2002

[Development of a CAN (controller area network) bus for modules of a perfused cell culture system].

For computer-aided data acquisition and automated running of experiments in cell cultivation reactors networking of all sensoric and actoric devices is required. A low cost and high performance solution to this demand can be found by using the widely established CAN (Controller Area Network) bus. If standard PCs running MS Windows are used to control this network special measures have to be taken to prevent loss of data caused by differences in the computing power of the PC on one hand and microcontroller-based devices on the other.

Cells, Cultured↗
PubMed2002

An open, component-based information infrastructure for integrated health information networks.

A fundamental requirement for achieving continuity of care is the seamless sharing of multimedia clinical information. Different technological approaches can be adopted for enabling the communication and sharing of health record segments. In the context of the emerging global information society, the creation of and access to the integrated electronic health record (I-EHR) of a citizen has been assigned high priority in many countries. This requirement is complementary to an overall requirement for the creation of a health information infrastructure (HII) to support the provision of a variety of health telematics and e-health services. In developing a regional or national HII, the components or building blocks that make up the overall information system ought to be defined and an appropriate component architecture specified. This paper discusses current international priorities and trends in developing the HII. It presents technological challenges and alternative approaches towards the creation of an I-EHR, being the aggregation of health data created during all interactions of an individual with the healthcare system. It also presents results from an ongoing Research and Development (R&D) effort towards the implementation of the HII in HYGEIAnet, the regional health information network of Crete, Greece, using a component-based software engineering approach. Critical design decisions and related trade-offs, involved in the process of component specification and development, are also discussed and the current state of development of an I-EHR service is presented. Finally, Human Computer Interaction (HCI) and security issues, which are important for the deployment and use of any I-EHR service, are considered.

Abstracting and Indexing↗
PubMed1999

Avoid the paper chase. Real-time, wireless patient documentation helps therapists save both time and money.

UNLABELLED: Good Shepherd Medical Center's physical therapy clinic, Longview, Texas. PROBLEM: Streamlining documentation processes in hard-to-reach areas of an off-site facility. SOLUTION: Implementing handheld, point-of-care devices for real-time documentation. RESULTS: Reduction in the time and effort physical therapists spend on "back office" documentation procedures. KEYS TO SUCCESS. "With the wireless link the staff doesn't have to concern itself with technical terms, uploads and network logons. They just enter their information by answering pre-programmed prompts. The information flows over to the host computer in real time."

Documentation↗
PubMed1996

[Installation of a local information network: case of Pasteur Institute of Madagascar].

The development of computer networks, especially Internet, leads to a new way of working organization. Internet mail represents a real progress in communication management for institutions far away from northern collaborating centres such as Institut Pasteur de Madagascar. The resources sharing capacities (hard disks, printers, back-up systems) induce important economies. Thus, the installation of an Ethernet network within the establishment is completely justified.

Academies and Institutes↗
PubMed1992

PathPics: an image-based instructional program used in the pathology and histology curriculum and transmitted over a wide area network.

PathPics is an image review and tutorial program developed at the University of California, San Diego (UCSD) School of Medicine as an adjunct to the preclinical Pathology and Histology curriculum. It incorporates faculty expertise and provides a framework for self-paced study of this visually-oriented material. The program is served over our wide area network and runs on color-capable Macintosh computers. PathPics was added to the curriculum in January, 1992, and has been enthusiastically received by the students.

Computer Graphics↗
PubMed1994

Integrating a digital dictation system with a network data base for creating and managing radiologic teaching files.

RATIONALE AND OBJECTIVES: A method for facilitating the creation and management of radiologic teaching files is described. METHODS: A digital dictation system was integrated with a personal computer data base. The data base is maintained with user-friendly, graphically oriented software. Radiologists can dictate any examination for the teaching file from any dictation station in the department with minimal interruption of their clinical activities. The data base resides on a file server, thus providing department-wide access for radiologists and students. RESULTS: Attending radiologists and residents have responded favorably to the system. Maintenance and retrieval of teaching files are facilitated by using a computer for otherwise tedious aspects of information management. Data are stored in a well-organized manner, thus increasing the value of the teaching file while reducing redundant data entry. CONCLUSION: Computer technology can facilitate the maintenance of radiologic teaching files. Radiology departments that have a convenient, department-wide method for entering cases--such as a digital dictation system and existing computer network--are ideal for the technique that we describe.

Humans↗
PubMed1991

Western State Hospital: implementing a MUMPS-based PC network.

Western State Hospital, a state-administered 1,200-bed mental health institution near Tacoma, Wash., confronted the challenge of automating its large campus through the application of the Healthcare Integrated Information System (HIIS). It is the first adaptation of the Veterans Administration's Decentralized Hospital Computer Program software in a mental health institution of this size, and the first DHCP application to be installed on a PC client/server network in a large U.S. hospital.

Hospital Bed Capacity, 500 and over↗