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PubMed1998

An integrated multimedia medical information network system.

An integrated multimedia medical information network system at Shimane Medical university has been developed to organize medical information generated from each section and provide information services useful for education, research and clinical practice. The report describes the outline of our system. It is designed to serve as a distributed database for electronic medical records and images. We are developing the MML engine that is to be linked to the world wide web (WWW) network system. To the users, this system will present an integrated multimedia representation of the patient records, providing access to both the image and text-based data required for an effective clinical decision making and medical education.

Academic Medical Centers↗
PubMed1995

Patient privacy in the era of medical computer networks: a new paradigm for a new technology.

For twenty five years the legal system has tried to protect the privacy of identified patient data contained in information systems. The rapid development of such technology has repeatedly frustrated the public policies incorporated into the legal system. However the newest information technologies provide the possibility of fundamentally changing the way information is stored in the health care system and, by "De personalizing the data," allow restoration of a reasonable level of personal privacy, without interfering with the legitimate needs for medical data. The system would require a secure "identifier control facility" and act as a network "file access table" able to reconstruct widely distributed bits of the patients record. A disaggregated "virtual record" would replace the integrated patient file, and the risks to data privacy inherent in the use of names or permanent identification numbers would be eliminated.

Computer Communication Networks↗
PubMed1997

Normative models and healthcare planning: network-based simulations within a geographic information system environment.

OBJECTIVES: Network analysis to integrate patient, transportation and hospital characteristics for healthcare planning in order to assess the role of geographic information systems (GIS). A normative model of base-level responses of patient flows to hospitals, based on estimated travel times, was developed for this purpose. DATA SOURCES/STUDY SETTING: A GIS database developed to include patient discharge data, locations of hospitals, US TIGER/Line files of the transportation network, enhanced address-range data, and U.S. Census variables. The study area included a 16-county region centered on the city of Charlotte and Mecklenburg County, North Carolina, and contained 25 hospitals serving nearly 2 million people over a geographic area of nearly 9,000 square miles. STUDY DESIGN: Normative models as a tool for healthcare planning were derived through a spatial Network analysis and a distance optimization model that was implemented within a GIS. Scenarios were developed and tested that involved patient discharge data geocoded to the five-digit zip code, hospital locations geocoded to their individual addresses, and a transportation network of varying road types and corresponding estimated travel speeds to examine both patient discharge levels and a doubling of discharge levels associated with total discharges and DRG 391 (Normal Newborns). The Network analysis used location/allocation modeling to optimize for travel time and integrated measures of supply, demand, and impedance. DATA COLLECTION/EXTRACTION METHODS: Patient discharge data from the North Carolina Medical Database Commission, address-ranges from the North Carolina Institute for Transportation Research and Education, and U.S. Census TIGER/Line files were entered-into the ARC/INFO GIS software system for analysis. A relational database structure was used to organize the information and to link spatial features to their attributes. PRINCIPAL FINDINGS: Advances in healthcare planning can be achieved by examining baseline responses of patient flows to distance optimization simulations and healthcare scenarios conducted within a spatial context that uses a normative model to integrate characteristics of population, patients, hospitals, and transportation networks. Model runs for the defined scenarios indicated that a doubling of the 1991 patient discharge levels resulted in an areal constriction of the service areas to those zip codes immediately adjacent to the hospitals, thereby leaving substantial areas unassigned to hospitals during the allocation process, but that doubling the demand for obstetrics care (DRG 391) resulted in little change in the pattern of accessibility to care as indicated by the size, orientation, and pattern of the service areas. CONCLUSIONS: The GIS-Network system supported "what if" simulations, portrayed service areas within a spatial context, integrated disparate data in the execution of the location/allocation model, and used estimated travel time along a transportation network instead of Euclidean distance for calculating accessibility. The results of the simulations suggest that the GIS-Network system is an effective approach for exploring a variety of healthcare scenarios where changes in the supply, demand, and impedance variables can be examined within a spatial context and where variations in system trajectories can be simulated and observed.

Computer Communication Networks↗
PubMed1996

A new task for the information literacy training by the university libraries: electronic media and computer networking.

Education and training of traditional information literacy, for librarians as well as for teachers and students, is no more adequate for current demands, even if well established and not over-sophisticated. The present electronic era in the information media and technology has not been fully adopted by all its users, although all of them acknowledge its high efficiency for learning, teaching, and research. Since the year 1993/94 the members of the Institute of Scientific Information (ISI) qualified in librarianship and medicine, prepared a course for pregraduate medical students (group A) and another one for postgraduates in biomedicine (group B). Since the year 1995/96 a course has been established for bachelor studies (C). Special courses or demonstrations corresponding to the demands of those users have been organized for teachers (group D) and for members of the ISI (group E). Group A (30 students/yr, a 4 hours course in "Medical Informatics") received theoretical and practical training in principles of bibliography oriented to searching in basic biomedical databases. Group B (60-80 st/yr, 24-28 hrs/yr in "The Craft of Science") was trained in principles of scientific communication and research data presentation incl. intensive workshops with databases. Group C (50 st/yr, 30 hrs/yr in "Scientific Information") received similar training as group B but with a more practical accentation. Group D (4 persons/yr, 20 hrs/yr) and E (15 p/yr, 30 hrs/yr) proposed their topics themselves. Besides, all the groups received intense training in Internet access. The lasting feed-back contact with the majority of participants of the above courses, mainly with researchers and postgraduate students, have confirmed the advantageousness of these ISI activities.

Computer Communication Networks↗
PubMed1991

An empirical analysis of likelihood-weighting simulation on a large, multiply connected medical belief network.

We are developing a probabilistic reformulation of the Quick Medical Reference (QMR) system. Our current probabilistic model of the QMR knowledge base of internal medicine consists of a two-level, multiply connected, belief network. Because of the size and connectivity of this belief network, most exact algorithms for calculating the posterior marginal probabilities of diseases are not applicable. In this paper, we analyze the convergence properties of an approximation algorithm, called likelihood-weighting simulation, on the QMR-DT belief network. Specifically, on two difficult diagnostic cases, we examine the effects of Markov blanket scoring, importance sampling, and self-importance sampling, demonstrating that the Markov blanket scoring and self-importance sampling significantly improve the convergence of the simulation on our model.

Algorithms↗
PubMed2003

Self-programming machines (II): Network of self-programming machines driving an Ashby homeostat.

The progress in artificial intelligence enables us to conceive adaptive systems whose characteristics are nearer and nearer to those of living beings. These characteristics though depend on ingenious choices by the designer of these systems: Initial conditions, parameters, optimisation functions, gradient and measure of fitness within the environment. Nevertheless, in living systems which are non-finalist, there are no programmers or designers to conceive of such ingenious choices. Our paper "Self-Programming Machines (I)" presents a non-finalist model since initial states and functions are randomly chosen at the beginning and once and for all. In spite of the fact that they are non-finalist, these machines always stabilise at fixed points when they are connected to an external process. This paper studies the dynamics of a mono-layered network of self-programming machines driving a real device. "the Ashby homeostat", and shows the striking properties of such networks. This system stabilises only at fixed points even if it is subjected to small perturbations or intentional breakdowns such as a reversal of power supply or disconnection of one or several motors. Real and simulated experiences are compared and theoretical results are demonstrated.

Artificial Intelligence↗
PubMedDate not supplied

A network architecture supporting consistent rich behavior in collaborative interactive applications.

Network architectures for collaborative virtual reality have traditionally been dominated by client-server and peer-to-peer approaches, with peer-to-peer strategies typically being favored where minimizing latency is a priority, and client-server where consistency is key. With increasingly sophisticated behavior models and the demand for better support for haptics, we argue that neither approach provides sufficient support for these scenarios and, thus, a hybrid architecture is required. We discuss the relative performance of different distribution strategies in the face of real network conditions and illustrate the problems they face. Finally, we present an architecture that successfully meets many of these challenges and demonstrate its use in a distributed virtual prototyping application which supports simultaneous collaboration for assembly, maintenance, and training applications utilizing haptics.

Communication↗
PubMedDate not supplied

Gaining links: health information networks arise--with integration challenges.

As chins gain favor and efficiency in several regions of the country, they are increasingly used to speed both financial and clinical data interchanges. Technologic advances in information management are shifting the laboratory from a passive entity generating data to an active medical support service.

Clinical Laboratory Information Systems↗
PubMedDate not supplied

The Cerec 3--a quantum leap for computer-aided restorations: initial clinical results.

The Cerec 3 system simplifies and accelerates the fabrication of ceramic inlays, onlays, veneers, and quarter, half, and complete crowns for anterior and posterior teeth. Cerec 3 software simplifies occlusal and functional registration. Proper occlusion is established accurately and quickly; manual adjustment is reduced to a minimum. The separate grinding device, working true to morphologic detail and with fine surface quality, is connected to the optical unit by radio control. Equipped with a laser scanner, it can also be used for indirect application through a standard personal computer. The Cerec 3 system is network and multimedia ready and, in combination with an intraoral color videocamera or a digital radiography unit, can be used for patient education and for user training. The Cerec 3 system thus is a diagnostic, restorative, training, and documentation center for the dental practice.

Adult↗
PubMed1995

Surfing the Internet.

More physicians are surfing the Internet than ever before, thanks to the recent launch of MSMSNET, the Michigan State Medical Society's new online service for physician members. If words like World Wide Web, E-mail, and Hypertext links send you into a state of confusion, then read on. This month's cover story discusses MSMS's launch into the information superhighway and training programs MSMS has in store for physician members. Also included is an examination of the Internet--past, present and future--by the president of Voyager Information Networks, Inc., a Michigan corporation specializing in Internet services for Michigan trade groups and other organizations, including MSMS. This cover story marks the beginning of a series of articles on the Internet which will appear in future issues of Michigan Medicine. Hop on board and enjoy the ride!

Computer Communication Networks↗
PubMed1996

Ka-boom! When disaster strikes.

When Hurricane Opal slammed Florida's gulf coast last October, Baptist Healthcare in Pensacola was in danger of a direct hit, putting the hospital's mainframe, minicomputers and telecommunications network--not to mention its patients--in peril. But Baptist had planned for just such a danger and, in the end, no harm was done. How would your hospital have fared? Here's what you can do now to make sure your hospital will keep running after disaster strikes.

Computer Communication Networks↗
PubMed2005

[Telematics and quality. Implementation of a telematic platform in Hamburg].

Since the end of the year 2000 a group of interested people has been working on the subject of quality improvement in breast cancer. Within this framework the project "improvement of breast cancer treatment by telemedicine" was started. Based on a workflow analysis and interviews with patients as well as health professionals, it turned out that there are gaps and flaws in the communication process. These problems occurred between health professionals involved in the treatment of patients and between health professionals and patients as well. As a result a telemedicine network has been developed which is based on MPLS technology. Within this network a central communication unit facilitates optimization of the workflow for the treatment of breast cancer. It will also be possible to set up groups for integrated care. Currently the system is being evaluated in specific breast centres in Hamburg. As the net is based on a positive business plan, it can be foreseen that a broad implementation will follow.

Breast Neoplasms↗
PubMed2006

Wireless industrial sensor networks: framework for QoS assessment and QoS management.

This paper presents a framework that addresses Quality of Service (QoS) for industrial wireless sensor networks as a real-time measurable set of parameters within the context of feedback control, thereby facilitating QoS management. This framework is based on examining the interaction between the industrial control processes and the wireless network. Control theory is used to evaluate the impact of the control/communication interaction, providing a methodology for defining, measuring, and quantifying QoS requirements. An example is presented illustrating the wireless industrial sensor network (WISN) QoS management framework for providing dynamic QoS control within WISN. The example focuses on WISN operating in a time-varying RF interference environment in order to manage application-driven QoS latency constraints.

Computer Communication Networks↗
PubMed2005

An artificial immune system approach with secondary response for misbehavior detection in mobile ad hoc networks.

In mobile ad hoc networks, nodes act both as terminals and information relays, and they participate in a common routing protocol, such as dynamic source routing (DSR). The network is vulnerable to routing misbehavior, due to faulty or malicious nodes. Misbehavior detection systems aim at removing this vulnerability. In this paper, we investigate the use of an artificial immune system (AIS) to detect node misbehavior in a mobile ad hoc network using DSR. The system is inspired by the natural immune system (IS) of vertebrates. Our goal is to build a system that, like its natural counterpart, automatically learns, and detects new misbehavior. We describe our solution for the classification task of the AIS; it employs negative selection and clonal selection, the algorithms for learning and adaptation used by the natural IS. We define how we map the natural IS concepts such as self, antigen, and antibody to a mobile ad hoc network and give the resulting algorithm for classifying nodes as misbehaving. We implemented the system in the network simulator Glomosim; we present detection results and discuss how the system parameters affect the performance of primary and secondary response. Further steps will extend the design by using an analogy to the innate system, danger signal, and memory cells.

Algorithms↗
PubMed1997

[Software support for automatic (computerized) work stations for dentists].

The authors describe the software for a basic computer unified system of working places for dentists specializing in oral, dental surgery and orthodontics with diaries and special entries for each section. The computer system head physician--registration office--primary examination room--rooms of dental treatment, physiotherapy, and x-ray examination--is intended for use as part of local computer network of dental clinics in the MS DOS and Windows systems. Application of the system improves the labor efficiency by up to 35% and the financial efficacy by almost 30%. It also warrants legal protection of both physicians and patients.

Computer Communication Networks↗
PubMed1993

Operational departmentwide picture archiving communication system analysis using discrete event-driven block-oriented network simulation.

The accurate prediction of image throughput is a critical issue in planning for and acquisition of any successful picture archiving and communication system (PACS). Simulation plays an important role in this effort. The PACS image management chain is decomposed into eight subsystems. These subsystems include network transfers over three different networks and five software programs and/or queueing structures. This decomposition is used to create a simulation model that was effectuated using commercially available block-oriented network simulation software. From the PACS database, the traffic generation patterns of the imaging modality devices are used to drive the simulation. The simulation models the image file flow through the PACS for a 24-hour period. The behavior of the simulated traffic generators agreed well with the values derived from the PACS database. The mean delay for the simulated PACS is found to be 225 +/- 59 seconds. The delay time was found to vary during the simulated 24-hour cycle in a consistent manner with observations. This simulation provides estimates on what a radiological department can expect from a PACS in terms of throughput, utilization, and delay. The block-oriented network simulator (BONeS, Comdisco Systems Inc, Foster City, CA) simulation model of the modeled PACS is highly accurate. The models for the imaging modality traffic sources are validated with a high degree of accuracy. The simulation model allows for the study of what happens to the delay time under various loads. In this simulation, the reformatting process was determined to be the bottleneck causing a large increase in delay time under heavy loads.

Computer Communication Networks↗
PubMed1996

The networked environment and the challenge of change.

The way for librarians to manage the environment of the future is to hold fast to their traditional skills and professional abilities. The challenges in the future environment include technology adoption, copyright, scholarly communication, and the role of professional medical societies. Four major areas in which librarians have skills valuable in this environment are the organization of knowledge, quality assurance of information, custodianship, and user instruction.

Catalogs, Library↗
PubMed1986

Electronic conferencing for continuing medical education: a resource survey.

The use of electronic technologies to link participants for education conferences is an option for providers of Continuing Medical Education. In order to profile the kinds of electronic networks currently offering audio- or videoteleconferences for physician audiences, a survey was done during late 1985. The information collected included range of services, fees, and geographic areas served. The results show a broad diversity of providers providing both interactive and didactic programming to both physicians and other health care professionals.

Computer Communication Networks↗