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At least 487 records · Page 27Linked to original sources

Applying the supply module to case carts.

When Hinsdale Hospital in Hinsdale, Illinois, decided to shift the pulling of cases from the Surgery Department to the Sterile Processing Department, a number of computer system changes had to be implemented to facilitate a smooth, functional transition. Seventy percent of the inventory carried in Surgery was transferred to SPD. To eliminate a cumbersome and uncoordinated supply requisition and pulling process that had existed in the OR, all written information had to be manually entered into a computer supply requisition module, and corrections made based on clinician "mental notes". This took the guesswork out of pulling and billing cases, from SPD's point of view. Additionally, new item numbers were assigned to indicate whether particular supplies were located in the OR or SPD. Hardware in the OR and SPD were networked together so the departments could share information and print requisitions in both locations. Finally, a detailed procedure on pulling cases was written for SPD to ease the transition and provide practice continuity for all SPD workers.

Central Supply, Hospital↗

Remote-rendered 3D CT angiography (3DCTA) as an intraoperative aid in cerebrovascular neurosurgery.

OBJECTIVE: To assess the viability and utility of network-based rendering in the treatment of patients with cerebral aneurysms, we implemented an intraoperative rendering system and protocol using both three-dimensional CT angiography (3DCTA) and perspective volume rendering (PVR). MATERIALS AND METHODS: A Silicon Graphics InfiniteReality engine was connected via a Fast Ethernet network to a workstation in the neurosurgical operating room. A protocol was developed to isolate bone and vessels using an appropriate transfer function. Three-dimensional CT angiogram images were volume rendered and transmitted to the workstation using a bandwidth-conserving remote rendering system, and were rotated, cut using clipping planes, and viewed using normal and perspective views. Twelve patients with intracranial aneurysms were examined at surgery using this system. RESULTS: Rendering performance at optimal operating bandwidths (50-60 Mb/s) was excellent, with regeneration of a high-resolution image in less than 1 s. Network performance varied in two cases, slowing image regeneration. Surgeons found the images to be useful as an adjunct to conventional imaging in understanding the morphology of complex aneurysms and their relationship to the skull base. CONCLUSIONS: Intraoperative volume rendering using 3DCTA is achievable over a network, can reduce hardware costs by amortizing hardware among multiple users, and provides useful imaging information during the surgical treatment of cerebral aneurysms. Future operating suites may incorporate network-transmitted three-dimensional images as additional sources of imaging information.

Aged↗

[Instrumental and programmed support for integration of diagnostic information within the local network].

The paper deals with the problems in the integration of diagnostic information obtained by various devices, suggests that this process should be implemented by local networks, considers the basic tasks arising with this approach, and gives how to solve some of them. It is shown that this approach can be applied when two basic subdivisions of a health institution: therapeutical and diagnostical--interact.

Diagnosis, Computer-Assisted↗

Linking and integrating computers for maternity care.

Functionally separate computer systems have been developed for many different areas relevant to maternity care, e.g. maternity data collection, pathology and imaging reports, staff rostering, personnel, accounting, audit, primary care etc. Using land lines, modems and network gateways, many such quite distinct computer programs or databases can be made accessible from a single terminal. If computer systems are to attain their full potential for the improvement of the maternity care, there will be a need not only for terminal emulation but also for more complex integration. Major obstacles must be overcome before such integration is widely achieved. Technical and conceptual progress towards overcoming these problems is discussed, with particular reference to the OSI (open systems interconnection) initiative, to the Read clinical classification and to the MUMMIES CBS (Common Basic Specification) Maternity Care Project. The issue of confidentiality is also briefly explored.

Confidentiality↗

Linking general practices to the medical schools: qualitative issues.

The University Linked Practices (ULP) programme links general practices involved in undergraduate medical education with computer services provided through the school of medicine and dentistry. In-depth interviews were conducted with 26 staff involved in teaching undergraduate medical students in 15 general practices across east London and Essex. The interview schedule focused on the use of the computer, IT experience and training needs and the use of the computer network as a resource in undergraduate teaching. It is important to work with curriculum planners to ensure that computers are fully integrated into new courses.

Computer Literacy↗

A network-based laboratory data processing system for use with the Coulter STKS haematology analyser.

A highly automated laboratory data processing environment for use with Coulter STKS haematology analysers is described. This in-house system is based on a network of personal computers running Novell Network software and communicating with an IBM mainframe. The system captures the leucocyte scatterplot graphic and numeric parameters from the blood analysers, integrating this with patient demographic and request data held on the host computer. This composite picture is then reviewed on the network by laboratory personnel before generating printed reports. The system has provided greater data integrity, reduced paper flow and improved efficiency in the laboratory's operations and lays the foundations for dealing effectively with the next generation of advanced haematology analysers.

Blood Cell Count↗

[Tina, a model for a supra-regional expert assessment information system].

A problem common to most medical assessment centres is how to avoid redoing work already done in a similar case? Or, more precisely, how to get knowledge about that similar case? The problem is aggravated by the companies' decentralization and the vast amount of yearly assessments. We present a model of an information system based on a public wide-area network which nevertheless complies with German law in respect of handling personal data. The system neither compiles a full-text data base, nor does it allow access to original documents. Instead, it automatically creates a thesaurus-based index file according to the users' specific queries. Each index points to the requested document giving its author and time of accomplishment. Upon written request the document will be mailed within the company. Internet technology is used, and hardware requirements are modest. As a hybrid system the Tina (thesaurus-based index file system with net access) model system guarantees data safety despite easy data base access. Its information is detailed, and the response time is adequate.

Abstracting and Indexing↗

On-line access to nursing literature.

Providing access to the multiple databases essential to nursing practice and education is a challenge for universities and health care providers alike. Collaboration between Wayne State University and other institutions in the Detroit metropolitan area provides a unique system for user access to nursing information. Building on the Detroit Area Library Network (DALNET) structure, additional computer databases have been added to the Library User Information System (LUIS) to allow faculty and student access from remote locations. With university identification, faculty and students access up-to-date literature-searching tools and check the availability of desired journal articles at multiple locations throughout the large tri-county area.

Abstracting and Indexing↗

Low cost, highly effective parallel computing achieved through a Beowulf cluster.

A Beowulf cluster is a means of bringing together several computers and using software and network components to make this cluster of computers appear and function as one computer with multiple parallel computing processors. A cluster of computers can provide comparable computing power usually found only in very expensive super computers or servers.

Benchmarking↗

[Electromagnetic fields in hospitals: wireless-LAN as a risk factor?].

The actual level of exposure to non-ionizing radiation in Swiss hospitals is not well known. Therefore, the electromagnetic field of wireless LAN (WLAN) and other non-ionizing radiation sources in the publicly funded Hospital Thun (Switzerland), where WLAN supports bedside access to the computerized patient record for more than three years, has been measured. The results are compared to the international and national exposure limits for the general public. Nurse workplaces as well as patient rooms show exposure levels well below the legal (national and international) exposure limits. In the investigated patients' room the electromagnetic field of GSM and broadband cellular phone networks are dominant, whereas at the nurse workplace WLAN exposure is the most important source of exposure. The results of a questionnaire survey emphasize, that the hospital staff does not worry much about electromagnetic fields of new ICT technologies.

Attitude of Health Personnel↗

Differences in urine volume and supersaturation in 2 physician networks.

PURPOSE: We determined whether a network of practices devoted to a broad range of urological care would achieve a decrease in metabolic stone risk comparable to that achieved by a network of similar practices that emphasized kidney stone management as a distinct specialized interest, provided that each was given equivalent access to high level urine testing and software support. MATERIALS AND METHODS: Pretreatment and treatment 24-hour urine samples were obtained from patients in a large network of practices related by the shared use of lithotripsy facilities and instruments (group 2) and a contrasting network of practices that emphasize stone treatment over other concerns (group 1). All known urine risk factors, including supersaturation, were measured and calculated. RESULTS: Treatment supersaturation values in group 2 exceeded those in group 1. The reason was unpredicted and unexplained but highly consistent lower urine volume in group 2 patients that was present before and persisted during treatment. Group 2 physicians mostly achieved changes in urine volume and stone risk factors equivalent to those of group 1 physicians but began with higher supersaturation due to lower urine volume. CONCLUSIONS: A network of physicians not specialized for stone care may achieve a decreased risk equivalent to that of more specialized physicians. Initial patient characteristics may vary significantly in the groups for reasons that are unknown to date, greatly affecting treatment outcome.

Calcium Oxalate↗

KIDSCARE: a network for children with special health care needs.

In December 1997, Arkansas Medicaid in cooperation with Title V and Children's Medical Services (CMS) implemented guidelines for the preauthorization of therapy services for Children with Special Health Care Needs (CSHCN). The University of Arkansas for Medical Sciences (UAMS) in partnership with Arkansas Medicaid (MCD), and Chidren's Medical Services (CMS) were given the charge of developing clinical practice guidelines for physical therapy (PT), occupational therapy (OT), and speech/language therapy (SLP) for this population based on primary diagnosis and age appropriateness. This process involved the implementation of a statewide, internet-based, clinical information support network. The objective of this article is to describe KIDSCARE, a clinical information support network, currently under development, for the determination of medical necessity and allocation of therapy services for CSHCN.

Academic Medical Centers↗

Computer-assisted centrifugal elutriation. I. Detection system and data acquisition equipment.

To optimize cell separations by centrifugal elutriation, we constructed an on-line computer-controlled multiparametric light-scatter system. A bypass sample flow, at the outlet of an elutriation rotor, is hydrofocussed and three scatter parameters of each cell are determined up to a maximum of 15,000 cells/second. The 18-bit representation of the parameter values are cumulatively stored by means of a direct memory access interface. The histogram memory is continuously displayed to provide information on the number and type of cells that are elutriated. A special purpose operating system, implemented on a stand-alone computer configuration, allows a high data-acquisition rate and ample data processing capacity. In addition, a local network driver was constructed to facilitate off-line detailed analysis of the data. The equipment is well suited to monitor the centrigural elutriation process. The flexibility of the system allows an extension of the monitor to computer-controlled elutriation.

Animals↗

A very large PC LAN as the basis for a hospital information system.

Brigham and Women's Hospital is converting its financial, administrative and clinical information systems from a mini-computer environment to a platform based on MUMPS and a network of several thousand personal computers. This article describes the project rationale and status and provides an overview of the architecture of the new system. The initial results of the project indicate that the personal computer network can provide large amounts of processor power and storage at costs per unit of power and storage that are several times less expensive than the minicomputer environment. The performance of the converted Accounts Payable system indicates that the architecture can deliver acceptable performance.

Hospital Information Systems↗

Medical Internet exchange project in Japan.

The Internet has been widely used by medical institutes and hospitals around the world, however; its use for telemedicine is still low. The main reason for this is the availability of bandwidth and poor security through the net. Meanwhile, we have established and have been operating 'Cancer Information Network' among 11 Cancer Centers in Japan, mainly for Multipoint TV Conference using HDTV image. There are also similar projects among 9 cardiovascular centers in Japan. By March, all 240 national hospitals will have been connected by an IP network using an ATM backbone. The above network projects are operated independently, and have an 'Intranet' characteristics within them. There are also many hospitals and clinics connected to the Internet by commercial internet providers. To make a secure and efficient network between these medical networks and medical sites, we started the Medical Internet eXchange project (MDX project) constructing a Medical Network Operation Center to create a link between them. To provide the administrative policy of this project, we established the Medical Internet eXchange Association. We are planning to expand this project to Asian-Pacific countries using the Asian-Pacific Advanced Network (APAN), and also expand it to worldwide connections in the future. For this purpose, we are currently asking other countries to form a structure similar to MDX-Japan. The concept, hardware system, software system, firewall configuration, and routing policy will be also discussed.

Computer Systems↗

A multileaf collimator field prescription preparation system for conventional radiotherapy.

PURPOSE: The purpose of this work is to develop a prescription preparation system for efficient field shaping using a multileaf collimator that can be used in community settings as well as research institutions. The efficiency advantage of the computer-controlled multileaf collimator, over cerrobend blocks, to shape radiation fields has been shown in conformal treatments, which typically require complete volumetric computerized tomographic data for three-dimensional radiation treatment planning--a utility not readily available to the general community. As a result, most patients today are treated with conventional radiation therapy. Therefore, we believe that it is very important to fully use the same efficiency advantage of multileaf collimator as a block replacement in conventional practice. METHODS AND MATERIAL: The multileaf collimator prescription preparation systems developed by us acquires prescription images from different sources, including film scanner, and radiation treatment planning systems. The multileaf collimator angle and leaf positions are set from the desired field contour defined on the prescription image, by minimizing the area discrepancies. Interactive graphical tools include manual adjustment of collimator angle and leaf positions, and definition of portions of the field edges that require maximal conformation. Data files of the final leaf positions are transferred to the multileaf collimator controller via a dedicated communication link. RESULTS: We have implemented the field prescription preparation system and a network model for integrating the multileaf collimator and other radiotherapy modalities for routine treatments. For routine plan evaluation, isodose contours measured with film in solid water phantom at prescription depth are overlaid on the prescription image. Preliminary study indicates that the efficiency advantage of the MLC over cerrobend blocks in conformal therapy also holds true for conventional treatments. CONCLUSION: Our model of computer-controlled prescription, evaluation, and treatment using multileaf collimators can be effectively implemented in both community settings and research institutions. The resultant increase in treatment efficiency and accuracy is now available for conventional radiotherapy.

Humans↗

Bringing the medical library to the office desktop.

This demonstration illustrates LRC Remote Computer Services- a dual operating system, multi-protocol system for delivering medical library services to the medical professional's desktop. A working model draws resources from CD-ROM and magnetic media file services, Novell and AppleTalk network protocol suites and gating, LAN and asynchronous (dial-in) access strategies, commercial applications for MS-DOS and Macintosh workstations and custom user interfaces. The demonstration includes a discussion of issues relevant to the delivery of said services, particularly with respect to maintenance, security, training/support, staffing, software licensing and costs.

CD-ROM↗

A semantic-based kernel for advanced health information systems.

This paper reports on the design and development of an infrastructure allowing one to share and exchange multimedia data in the context of a health network. A single technology exploiting a semantic model of the hospital universe provides users with information and data of diverse origins, generated by the various actors or departments of the health organization. Functions provided include act management and patient record management governed by domain semantics. The functionality has been validated through laboratory experiments against the requirements of protocol directed care and health networks. The functionality is integrated into a clinician workstation exploited in the Internet/Intranet environment thanks to a commercial browser. These results have been obtained with the support of several projects in the frame of the Health-Care Telematics Applications Programme of the European Community and of the Eurêka Programme.

Artificial Intelligence↗