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PubMed1995

Networking a need: a cost-effective approach to statewide health information delivery.

VTMEDNET is the health information network for the state of Vermont. In response to a needs assessment of rural health care providers, it supports e-mail, access to knowledge-bases, and the ability to request library services for health care providers across the state, regardless of their location or affiliation. For Fletcher Allen Health Care affiliates, it also supports access to in-patient hospital records. Two thirds of the state's physicians are using the network as well as many other health care providers, and, with minimal cost, it has begun to meet its goal of improving health care delivery to many of Vermont's citizens.

Attitude to Computers↗
PubMed1997

Improving access to knowledge-based health sciences information: early results from a statewide collaborative effort.

Access to biomedical literature has been shown to reduce the patient's length of stay and thus reduce the cost of the hospital visit. Unfortunately, access to the most current information, at the time and place of need, requires a substantial commitment of resources in the form of staff expertise, computer hardware and software, and user training. The cost of these resources may be prohibitively high for all but the largest institutions. The Arizona Health Information Network (AZHIN) brings together librarians, information systems specialists, and health care professionals from hospitals throughout the state in an effort to share resources and expertise. By reducing the cost of access, AZHIN has increased the availability of health-related information across the state. Progress in AZHIN's first two years is described.

Arizona↗
PubMed2004

Design of a peer-to-peer telerehabilitation model.

PURPOSE: To describe the design and development process for an information network that meets the complex needs for information exchange by persons with disabilities. This paper describes the needs assessment and design processes that drove the selection of specific system features, and discusses the range of entities with whom persons with disabilities must exchange information. The authors delineate the design goals and their associated specifications for a network of local resource information that serves the needs of persons with disabilities. A model program has been specified and is currently under development. It will enable users to exchange personal, health, and resource information with service entities and with other members of the disability community who depend on detailed information to support their performance of everyday tasks. As an outcome this activity, a highly portable, replicable, sustainable, scalable, and secure model of consumer-driven information exchange will become available to persons with disabilities and to those who provide services to them. The impact of this system will be amplified when it is launched and replicated in interested communities nationwide.

Persons with Disabilities↗
PubMed2003

RESHEN, a best practice approach for secure healthcare networks in Europe.

Electronic communication of healthcare related information (in the framework of Regional Healthcare Information Networks), introduces a number of security risks with regard to confidentiality, integrity and availability, which can become quite crucial taking into account its sensitive nature. Public Key Infrastructure (PKI) is acknowledged as an appropriate means for dealing with such risks, as long as all the involved critical factors are first practically assessed. This paper presents a best-practice approach for secure regional healthcare networks in Europe, examining all the identified crucial parameters (technical, organisational, legal/regulatory, medical and business). Our approach is conducted at two levels (the regional and the European), including the integration of PKI-aware security mechanisms (strong authentication, encryption, digital signature, time-stamping) in three regional pilot sites in Greece, Finland and Germany and demonstrating their interconnection in a pan-European architecture. Following the above approach, some major conclusions are excluded, pointing out existing open issues and possible steps forward.

Access to Information↗
PubMed2000

ARCHIMED: a Network of Integrated Information Systems.

ARCHIMED is a Network of Integrated Information Systems (NIIS). This novel concept of hospital information system has a major advantage over the currently used distributed systems. The normalized representation structure of its databases enable its Navigators to reach simultaneously not only the data coming from different hospital departments, laboratories, and other hospital facilities, but also the data from different hospitals associated in the network.

Computer Communication Networks↗
PubMed1983

A network approach to rural psychiatric emergency training.

The relative lack of objective data delineating rural needs has limited the development of creative training programs. The authors describe the process of developing a network approach to teaching psychiatric emergency skills. Using information collected from questionnaires, they defined the attributes of the rural setting, the emergency services, the staff, and the patients, and then tailored a program to meet these needs. The questionnaire results suggested that the extensive informal network of crisis care providers gives rural emergency services their unique character. The authors conclude that a successful training workshop should gather together members of both informal and formal networks to address group process and teaming issues. The faculty, consisting of urban and rural staff, must also overcome regional differences to build an effective working alliance.

Adolescent↗
PubMed1995

Implementing hospital library automation: the GaIN project. Georgia Interactive Network for Medical Information.

The GaIN (Georgia Interactive Network for Medical Information) Hospital Libraries' Local Automation Project was a one-year, grant-funded initiative to implement an integrated library system in three Georgia hospitals. The purpose of the project was to install the library systems, describe the steps in hospital library automation, and identify issues and barriers related to automation in small libraries. The participating hospitals included a small, a medium, and a large institution. The steps and time required for project implementation were documented in order to develop a decision checklist. Although library automation proved a desirable approach for improving collection accessibility, simplifying daily routines, and improving the library's image in the hospital, planners must be sure to consider equipment as well as software support, staffing for the conversion, and training of the library staff and end users.

Catalogs, Library↗
PubMed1998

Trends in medical information retrieval on Internet.

Information on the World Wide Web is unstructured, distributed, multimedia and multilingual. Many tools have been developed to help users search for useful information: subject hierarchies, general search engines, browsers and search assistants. Although helpful, they present serious limitations, mainly in terms of precision, multilingual indexing and distribution. In this paper, we cover some on-line solutions to medical information discovery and present our own approach, the MARVIN (multi-agent retrieval vagabond on information network) project, which tackles medical information research with specialized cooperative retrieval agents. We also draw some outlines for future extensions.

Computer Systems↗
PubMed2000

New media technology and youth: trends in the evolution of new media.

An information environment is emerging from the simultaneous, rapid, and interconnected evolution of transmission systems, interfaces, and content quantity, quality, and structure. It will be easy to underestimate the collective impact of the sum of these changes on how young people communicate and absorb information. Ultimately, it will be more important to understand how these technologies will facilitate, amplify, or alter the cognitive processes and/or social behavior of the Internet generation. The article analyzes the impact of the following trends on media use and cognition among youthful users: * Information expansion and overload: Accessible networked information will continue to grow at a rapid pace for at least the next 10-20 years. * Rapid increase in interface diffusion: The number of access points into the Internet is expanding in number, variety, and mobility. * Evolution toward more embodied computing: Interfaces are evolving to use more of the sensorimotor system to transfer information to and from the user. * The evolution of more intelligent sensors to interpret use behavior and intentions. * Evolution toward anthropomorphic agent techniques: Computers are evolving to use more social and interpersonal communication techniques to interact with the user.

Adolescent↗
PubMed2004

Network-induced oscillatory behavior in material flow networks and irregular business cycles.

Network theory is rapidly changing our understanding of complex systems, but the relevance of topological features for the dynamic behavior of metabolic networks, food webs, production systems, information networks, or cascade failures of power grids remains to be explored. Based on a simple model of supply networks, we offer an interpretation of instabilities and oscillations observed in biological, ecological, economic, and engineering systems. We find that most supply networks display damped oscillations, even when their units--and linear chains of these units--behave in a nonoscillatory way. Moreover, networks of damped oscillators tend to produce growing oscillations. This surprising behavior offers, for example, a different interpretation of business cycles and of oscillating or pulsating processes. The network structure of material flows itself turns out to be a source of instability, and cyclical variations are an inherent feature of decentralized adjustments.

Journal Article↗
PubMed2002

Integrating the lightweight authentication protocol (LAP) with access control mechanisms in wireless health care information systems.

Health information networks are expected to support information exchange that is authentic, accurate, private and available when, where and to whom is needed. With the increase of the shared medical information and resources in healthcare wireless information systems, unauthorized access to the information by illegal users also increases. The security of the transmitted information is a vital issue. In this paper, we report on the development of the Lightweight Authentication Protocol (LAP), which makes a mobile and distributed system more secure and flexible and we implement it in a Health Care Environment where the clinicians use mobile and wireless devices like PDAs. We also provide an indicative example of integrating the LAP with access control mechanisms. Context-based Team Access Control (C-TMAC) model is used in this example, since it provides great flexibility on user-permissions management in collaborative healthcare environments. LAP is indeed capable to support efficiently the advanced authorization procedures of such demanding active security models.

Computer Security↗
PubMed2004

External control in Markovian genetic regulatory networks: the imperfect information case.

Probabilistic Boolean Networks, which form a subclass of Markovian Genetic Regulatory Networks, have been recently introduced as a rule-based paradigm for modeling gene regulatory networks. In an earlier paper, we introduced external control into Markovian Genetic Regulatory networks. More precisely, given a Markovian genetic regulatory network whose state transition probabilities depend on an external (control) variable, a Dynamic Programming-based procedure was developed by which one could choose the sequence of control actions that minimized a given performance index over a finite number of steps. The control algorithm of that paper, however, could be implemented only when one had perfect knowledge of the states of the Markov Chain. This paper presents a control strategy that can be implemented in the imperfect information case, and makes use of the available measurements which are assumed to be probabilistically related to the states of the underlying Markov Chain.

Algorithms↗
PubMed2005

Rural telemedicine infrastructure and services in the Department of Cauca, Colombia.

The development of telemedicine programs for the public health network of the Department of Cauca, Colombia, (Department is the major political and territorial division of the country. The Department of Cauca is located on the Pacific coast in the southwest of the country.) would make it possible to satisfy many identified needs such as medical coordination, continuing education, epidemiologic surveillance, patient referral and counterreferral, and an end to the feeling of isolation among professionals who work in rural health centers. Nevertheless, geographic, economic, and social difficulties, and the lack of a telecommunication infrastructure in areas with these characteristics present a challenge of such magnitude that the majority of existing telemedicine projects in Colombia have been centered in urban or other areas which present fewer difficulties. In the municipality of Silvia, the University of Cauca has established a prototype network using the "Hispano-American Health Link" (EHAS in Spanish) program technologies, which uses very high frequency (VHF) and wireless fidelity, (WiFi, a set of standards for wireless local area networks) radio systems for the deployment of low-cost voice and data networks. Over this network information access and exchange services have been developed, in order to meet the needs identified above. The objectives were to obtain information about the development of the project's activities and their possible impact. Project telecommunication network and information services are described, and the results and conclusions of the first evaluation are presented.

Colombia↗
PubMed2006

[Description and integration of biomedical information resources by metadata].

With the development and utilization of computer techniques, Internet is playing an important role in information dissemination. There are abundant biomedical resources on the Internet. Accessing biomedical information is more dependent on the Internet than ever. It is important to explore new methods to describe and manage information resources. We have analyzed biomedical databases, search engines, web sites, and the metadata adopted by biomedical databases. The results show that biomedical information resources are characterized by electronic format, networking, dynamia, and dispersion. Describing a resource with metadata allows it to be understood by both humans and machines in ways that promote interoperability. Metadata interoperability has to be the underlying principle for networked information management. It directly impinges on information sharing, interchange, and accessibility across the boundaries of systems, languages, and geographic locations. We can use metadata to describe biomedical information and to integrate resources. It will benefit the people to access, select, and utilize biomedical information resources.

Computer Communication Networks↗
PubMed1989

Accessing the biomedical literature: the South Dakota Med-Fax Network.

Librarians developed a plan for a medical information network based upon the needs of South Dakota physicians as revealed in a 1984 survey. The South Dakota Med-Fax Network received private funding in 1987 and became operational in 1988. The Network incorporates interactive simultaneous remote on-line database searching (ISRS) and telefacsimile transmission to expedite the identification and delivery of medical literature to South Dakota physicians. At present, the Network is composed of sixteen institutional sites. Individual physicians may establish their own sites if they provide an IBM compatible personal computer with a modem and purchase a telecommunications software package. The Network will provide training and follow-up support. Use patterns to date demonstrate that telefacsimile transmission is instrumental in reducing significantly the time necessary to deliver journal literature and that ISRS searching is the method of choice in the Network's remote sites.

Humans↗
PubMed2004

Communities' readiness for health information exchange: the National Landscape in 2004.

BACKGROUND: The Secretary of Health and Human Services recently released a report calling for the nation to create a national health information network (NHIN) that would interconnect Regional Health Information Organizations (RHIOs). These RHIOs, which others have called Local or Regional Health Information Infrastructures (LHII), would in turn interconnect local as well as national health information resources. Little data exist about the activities taking place in communities to create LHIIs. APPROACH: The authors analyzed data that communities submitted in response to a request for capabilities issued by the Foundation for eHealth as part of their Connecting Communities for Better Health program using descriptive statistics and subjective evaluation. IMPRESSION: The authors analyzed data from 134 responses from communities in 42 states and the District of Columbia. Communities are enthusiastic about moving forward with health information exchange to create LHIIs to improve the efficiency, quality, and safety of care. They have identified significant local sources of investment and plan to use some clinical data standards but not as broadly as was expected. The communities have not yet developed the specific technical approaches or the sustainable business models that will be required. Many communities are interested in creating an LHII and are developing the leadership commitment needed to translate that interest into an operational reality. Clinical information standards can be incorporated into a community's plans as often as they need to be. Communities have to overcome funding issues, develop deeper understanding of the technical and organizational issues, and aggressively share their learning to succeed within their community and to help other communities succeed.

Community Networks↗
PubMedDate not supplied

The outcome of pregnancy in 689 women exposed to therapeutic doses of antidepressants. A collaborative study of the European Network of Teratology Information Services (ENTIS).

The European Network of the Teratology Information Services (ENTIS) has collected and evaluated data on 689 pregnancies in which exposure to tricyclic and nontricyclic antidepressants occurred. Data were collected prospectively from the time of in utero exposure and all the cases were followed up to the first few weeks of postnatal life using standardized procedures. In most cases, no longer term follow-up data were available. Approximately two-thirds of the mothers were on multidrug therapy, and of those, half took a benzodiazepine. About 95% of the patients were exposed during the first trimester. The most striking feature of the pregnancy outcomes is that 97% of live-born babies were morphologically normal. The incidence of spontaneous abortion and late fetal/neonatal deaths were within the normal range. Fourteen live-born babies and one fetus had either major or minor malformations, and six had minor anomalies. However, there was no increase in either a particular type of malformation or a specific pattern of defects. Another 31 infants without malformations had neonatal problems; these were usually associated with chronic multidrug therapy, especially near term. Elective termination of pregnancy occurred more frequently in the multidrug groups (86 out of 488) than in the monotherapy groups (20 out of 201), but data concerning the condition of the fetus are not available in the majority of the cases. Overall, no causal relationship could be established between in utero exposure to antidepressants and adverse pregnancy outcome.

Abnormalities, Drug-Induced↗