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PubMed1998

Clinical information systems for integrated healthcare networks.

In the 1990's, a large number of hospitals and medical practices have merged to form integrated healthcare networks (IHN's). The nature of an IHN creates new demands for information management, and also imposes new constraints on information systems for the network. Important tradeoffs must be made between homogeneity and flexibility, central and distributed governance, and access and confidentiality. This paper describes key components of clinical information systems for IHN's, and examines important design decisions that affect the value of such systems.

Computer Communication Networks↗
PubMed1995

A strategy for database interoperation.

To realize the full potential of biological databases (DBs) requires more than the interactive, hypertext flavor of database interoperation that is now so popular in the bioinformatics community. Interoperation based on declarative queries to multiple network-accessible databases will support analyses and investigations that are orders of magnitude faster and more powerful than what can be accomplished through interactive navigation. I present a vision of the capabilities that a query-based interoperation infrastructure should provide, and identify assumptions underlying, and requirements of, this vision. I then propose an architecture for query-based interoperation that includes a number of novel components of an information infrastructure for molecular biology. These components include a knowledge base that describes relationships among the conceptualizations used in different biological databases, a module that can determine the DBs that are relevant to a particular query, a module that can translate a query and its results from one conceptualization to another, a collection of DB drivers that provide uniform physical access to different database management systems, a suite of translators that can interconvert among different database schema languages, and a database that describes the network location and access methods for biological databases. A number of the components are translators that bridge the heterogeneities that exist between biological DBs at several different levels, including the conceptual level, the data model, the query language, and data formats.

Artificial Intelligence↗
PubMed2005

Adaptive diagnosis in distributed systems.

Real-time problem diagnosis in large distributed computer systems and networks is a challenging task that requires fast and accurate inferences from potentially huge data volumes. In this paper, we propose a cost-efficient, adaptive diagnostic technique called active probing. Probes are end-to-end test transactions that collect information about the performance of a distributed system. Active probing uses probabilistic reasoning techniques combined with information-theoretic approach, and allows a fast online inference about the current system state via active selection of only a small number of most-informative tests. We demonstrate empirically that the active probing scheme greatly reduces both the number of probes (from 60% to 75% in most of our real-life applications), and the time needed for localizing the problem when compared with nonadaptive (preplanned) probing schemes. We also provide some theoretical results on the complexity of probe selection, and the effect of "noisy" probes on the accuracy of diagnosis. Finally, we discuss how to model the system's dynamics using dynamic Bayesian networks (DBNs), and an efficient approximate approach called sequential multifault; empirical results demonstrate clear advantage of such approaches over "static" techniques that do not handle system's changes.

Algorithms↗
PubMedDate not supplied

[Al-assisted, transputer based EMG system--concept, components and initial results].

An EMG system has been developed capable of doing an EMG analysis as well as providing diagnostic support with the aid of an integrated expert system. The goal of this EMG system is to reduce the time of examination and to increase the reliability of the diagnosis. In order to obtain many parameters from the EMG signal, different analysing methods capable of running in parallel are needed. The system has been realized with a transputer network. Thus it is possible to distribute the software components to different processors with high level of efficiency. For software development we use the operating system Helios. This makes it possible to use the standard I/O environment X-Windows.

Computer Communication Networks↗
PubMed2004

An adaptive mechanism to guarantee the bandwidth fairness of TCP flows.

End-to-end TCP (transmission control protocol) congestion control can cause unfairness among multiple TCP connections with different RTT (Round Trip Time). The throughput of TCP connection is inversely proportional to its RTT. To resolve this problem, researchers have proposed many methods. The existing proposals for RTT-aware conditioner work well when congestion level is low. However, they over-protect long RTT flows and starve short RTT flows when congestion level is high. Due to this reason, an improved method based on adaptive thought is proposed. According to the congestion level of networks, the mechanism can adaptively adjust the degree of the protection to long RTT flows. Extensive simulation experiments showed that the proposed mechanism can guarantee the bandwidth fairness of TCP flows effectively and outperforms the existing methods.

Algorithms↗
PubMed1997

Telemedicine for AIDS patients accommodations.

People suffering from AIDS are subject to frequent hospitalisations. In some cases, they cannot go back home after hospitalisations, due to severe illness, family or sociologic problems. This is the reason why some therapeutic flats are at their disposal to make easier their medical follow-up after the hospital's discharge. In these Therapy Accommodation, they are treated by trained GP who often suffer from lack of information and lack of expertise in difficult cases. For this purpose we included these flats in the regional Telemedicine AIDS network to give these physicians free access to the computerised multimedia medical record of their patients and to provide them with synchronous co-operation facilities.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Task and training requirements analysis methodology (TTRAM): an analytic methodology for identifying potential training uses of simulator networks in teamwork-intensive task environments.

A methodology designed to identify potential application areas for use of networked simulations is presented. The technique, known as task and training requirements analysis methodology (TTRAM), has been independently applied to the analysis of numerous US military aircraft simulator networking requirements, and appears to effectively discriminate tasks that are prone to skill decay, that are critical to mission success, that require high levels of internal and external teamwork, and that require additional training support.

Aviation↗
PubMed1996

Beyond the hyperactive molecule: search, salvage and visualization of chemical information from the Internet.

The established exchange mechanisms for chemical information are under attack from new information distribution channels on the Internet. Increasingly chemical information is distributed by means of WWW pages and similar media. However, most of this information is still primarily intended for human browsing. The search for chemical information and the reuse of encoded structures and their attached data is complicated and often impossible because of the unorganized structure of the information and the lack of tools for search, display and salvage of chemical information to help with the extraction of reusable information from Webspace. The situation is complicated by the lack of standards and formats powerful enough to encode in computer-readable form sophisticated chemical information and informational relationships. The rapid evolution of information exchange mechanisms on the Internet is another problem. The unsettled situation demands a new generation of intelligent chemistry-aware tools for information retrieval from the Net. These tools must be capable of adapting to new trends and information models as well as new information types without constant redesign and should be themselves extendable and updatable by components distributed via the same network connections as the chemical data they are supposed to deal with. We introduce a set of tools which encapsulate the established Internet (especially WWW) information transfer and visualization methods and extend them to a new level of chemical information handling.

Chemistry↗
PubMed1987

Information system linking a medical school with practitioners and hospitals.

A recently established medical information network uses computers and telephone lines to link rural Georgia medical practitioners, Georgia hospitals, and the Mercer University School of Medicine (MUSM) in Macon, Georgia. This network, the Georgia Interactive Network for Medical Information (GaIN), provides a service and educational support system for its members. The GaIN model embodies many of the educational and information management principles endorsed by two reports by the Association of American Medical Colleges: the 1984 report of the Project Panel on the General Professional Education of the Physician and a 1982 project report called "Academic Information in the Academic Health Sciences Center." The design, services, utilization patterns, and results of the GaIN project and implications for the network's future are described. Use of the GaIN has made MUSM students more at ease with computers, has connected MUSM with remote teaching sites and rural practices, and has served as a catalyst for Georgia physicians' investigation of computer applications to support health care delivery in the state.

Computer Communication Networks↗
PubMedDate not supplied

Design of remote control units for seniors.

HumRRO International, Inc. conducted a project to improve the human factors aspects of remote control unit (RCU) design. Although the research was oriented toward RCUs for future telerobots that older adults may use, the RCUs examined were currently available models. An observational study found that a sample of 18 persons aged 65-88 years made errors in performing a simple arithmetic task with four different handheld calculators and that 13 participants made errors operating 11 VCR remotes. Better human-machine designs in RCUs appear to be needed to reduce errors that might cause accidents in the future use of mobile telerobots and their manipulators. In addition, manufacturers of RCUs, gerontologists, and members of SeniorNet, a network of older adults interested in computers, were queried regarding the design of RCUs. The responses of these individuals and the participants in the observational study, together with human factors engineering analyses, suggested numerous design improvements that may be systematically examined.

Aged↗
PubMed1995

The crucial roles of standards and strategy in developing a regional health information network.

Contemporary medical practice increasingly involves the use of inter-professional teams and complex care protocols. Increasing emphasis on value for money, medical audit, quality assurance and optimal outcomes requires that the practitioner has ready access to large amounts of up-to-date information, and that various abstracts and summaries of cases are made available quickly to providers, purchaser/funders, statisticians and researchers, and others. Rapid movements of large quantities of information is vital for the future success of health care: development of health information networks are vital strategic goals. In 1991 New Zealand initiated a widespread process of health services reform, whose success depended upon better availability and faster movements of information. The first phase of a national network to support these needs was successfully implemented in mid 1993: this provided for a point of connection for all individuals and organisations involved in the health sector, using commercial networking services. Fundamental to this development has been the adoption adaptation and development of appropriate standards and specifications for interconnection profiles, communications protocols, message formats, privacy and security requirements classification and coding systems and data element definitions. These have been selected to provide the maximum utility whilst imposing the minimum of constraints on the diversity of end user systems.

Computer Communication Networks↗
PubMedDate not supplied

A fix at the University of Texas Medical Branch.

PROBLEM: A well established teaching hospital geographically isolated is having difficulty getting physicians to refer patients to its island location. SOLUTION: 1) Purchase an electronic network connecting the hospital with physicians within about a 100-mile radius of the hospital; 2) choose a network that offers physicians insurance and demographic information, test results from various hospital departments. The network also will offer physicians the ability to complete pre-admission paperwork for a patient on the system, as well as obtain discharge summaries. Physicians also will be able to use the teaching hospital's medical library in their offices or in their homes.

Catchment Area, Health↗
PubMed2004

A hybrid Hopfield network-genetic algorithm approach for the terminal assignment problem.

This paper presents a hybrid Hopfield network-genetic algorithm (GA) approach to tackle the terminal assignment (TA) problem. TA involves determining minimum cost links to form a communications network, by connecting a given set of terminals to a given collection of concentrators. Some previous approaches provide very good results if the cost associated with assigning a single terminal to a given concentrator is known. However, there are situations in which the cost of a single assignment is not known in advance, and only the cost associated with feasible solutions can be calculated. In these situations, previous algorithms for TA based on greedy heuristics are no longer valid, or fail to get feasible solutions. Our approach involves a Hopfield neural network (HNN) which manages the problem's constraints, whereas a GA searches for high quality solutions with the minimum possible cost. We show that our algorithm is able to achieve feasible solutions to the TA in instances where the cost of a single assignment in not known in advance, improving the results obtained by previous approaches. We also show the applicability of our approach to other problems related to the TA.

Algorithms↗
PubMed1991

Data protection in networks.

Health Data are sensitive to loss, manipulation and breach of confidentiality. Systems handling health data must be especially secure. Anyone accessing health data-be they stored in data banks or in personalized chip-cards-must be specifically authorized to do so and must be strongly authenticated before access is granted.

Computer Communication Networks↗
PubMed1997

World Wide Web interface for advanced SPECT reconstruction algorithms implemented on a remote massively parallel computer.

Data from Single Photon Emission Computed Tomography (SPECT) studies are blurred by inevitable physical phenomena occurring during data acquisition. These errors may be compensated by means of reconstruction algorithms which take into account accurate physical models of the data acquisition procedure. Unfortunately, this approach involves high memory requirements as well as a high computational burden which cannot be afforded by the computer systems of SPECT acquisition devices. In this work the possibility of accessing High Performance Computing and Networking (HPCN) resources through a World Wide Web interface for the advanced reconstruction of SPECT data in a clinical environment was investigated. An iterative algorithm with an accurate model of the variable system response was ported on the Multiple Instruction Multiple Data (MIMD) parallel architecture of a Cray T3D massively parallel computer. The system was accessible even from low cost PC-based workstations through standard TCP/IP networking. A speedup factor of 148 was predicted by the benchmarks run on the Cray T3D. A complete brain study of 30 (64 x 64) slices was reconstructed from a set of 90 (64 x 64) projections with ten iterations of the conjugate gradients algorithm in 9 s which corresponds to an actual speed-up factor of 135. The technique was extended to a more accurate 3D modeling of the system response for a true 3D reconstruction of SPECT data; the reconstruction time of the same data set with this more accurate model was 5 min. This work demonstrates the possibility of exploiting remote HPCN resources from hospital sites by means of low cost workstations using standard communication protocols and an user-friendly WWW interface without particular problems for routine use.

Algorithms↗
PubMed2002

Body Area Network BAN--a key infrastructure element for patient-centered medical applications.

The Body Area Network (BAN) concept enables wireless communication between several miniaturized, intelligent Body Sensor (or actor) Units (BSU) and a single Body Central Unit (BCU) worn at the human body. A separate wireless transmission link from the BCU to a network access point--using different technology--provides for online access to BAN data via usual network infrastructure. BAN is expected to become a basic infrastructure element for service-based electronic health assistance: By integrating patient-attached sensors and control of mobile dedicated actor units, the range of medical workflow can be extended by wireless patient monitoring and therapy support. Beyond clinical use, professional disease management environments, and private personal health assistance scenarios (without financial reimbursement by health agencies/insurance companies), BAN enables a wide range of health care applications and related services.

Artificial Intelligence↗
PubMed1987

DXplain. An evolving diagnostic decision-support system.

DXplain is an evolving computer-based diagnostic decision-support system designed for use by the physician who has no computer expertise. DXplain accepts a list of clinical manifestations and then proposes diagnostic hypotheses. The program explains and justifies its interpretations and provides access to a knowledge base concerning the differential diagnosis of the signs and symptoms. DXplain was developed with the support and cooperation of the American Medical Association. The system is distributed to the medical community through AMA/NET--a nationwide computer communications network sponsored by the American Medical Association--and through the Massachusetts General Hospital Continuing Education Network. A key element in the distribution of DXplain is the planned collaboration with its physician-users whose comments, criticisms, and suggestions will play an important role in modifying and enhancing the knowledge base.

Artificial Intelligence↗
PubMed1997

[The digital image archive--its clinical applications and importance in cardiology consulting by telemedicine].

The revolution in digital technology is rapidly changing the world of telecommunications. Its applications to Medicine, and in particular to Cardiology, offer enormous benefits since communication is an essential part of medical practice. The need to improve the management of medical information is critical because of the explosion of medical knowledge, and the need to provide comprehensive documentation on patient care. The availability of a network offers many possibilities for clinical, research and teaching activities. Relevant, up-to-date scientific information is instantly available for analysis and interaction. The authors review the issue of digital communications as well as its potential application to Telemedicine, and present their preliminary experience with digital analysis and storage of echocardiographic images.

Cardiology↗