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PubMed1993

Communication networks for medical image transmission.

Digital communication networks are of increasing importance for data exchange in health care environments. They may be used to transmit multi-media data, such as text, images, graphics, signals and sound. The essential characteristics of modern network technologies are summarized in this article and are seen in the context of local, metropolitan and wide area networks. Standardized technologies discussed are Ethernet, token oriented systems, FDDI, DQDB and ATM. Off-line communication media based on magnetic optical disk, such as IS&C, are briefly introduced. The conclusion reached is that therapy planning for radiation therapy or hyperthermia can make use of communication technologies, for example, to transmit patient images, modelling data and results of distribution calculations of physical phenomena.

Computer Communication Networks↗
PubMed2004

Live broadcast of laparoscopic surgery to handheld computers.

BACKGROUND: Thanks to advances in computer power and miniaturization technology, portable electronic devices are now being used to assist physicians with various applications that extend far beyond Web browsing or sending e-mail. Handheld computers are used for electronic medical records, billing, coding, and to enable convenient access to electronic journals for reference purposes. The results of diagnostic investigations, such as laboratory results, study reports, and still radiographic pictures, can also be downloaded into portable devices for later view. Handheld computer technology, combined with wireless protocols and streaming video technology, has the added potential to become a powerful educational tool for medical students and residents. The purpose of this study was to assess the feasibility of transferring multimedia data in real time to a handheld computer via a wireless network and displaying them on the computer screens of clients at remote locations. METHODS: A live laparoscopic splenectomy was transmitted live to eight handheld computers simultaneously through our institution's wireless network. RESULTS: All eight viewers were able to view the procedure and to hear the surgeon's comments throughout the entire duration of the operation. CONCLUSION: Handheld computer technology can play a key role in surgical education by delivering information to surgical residents or students when they are geographically distant from the actual event. Validation of this new technology by conducting clinical research is still needed to determine whether resident physicians or medical students can benefit from the use of handheld computers.

Audiovisual Aids↗
PubMed1991

MDA-image: an environment of networked desktop computers for teleradiology/pathology.

MDA-Image, a project of The University of Texas M. D. Anderson Cancer Center, is an environment of networked desktop computers for teleradiology/pathology. Radiographic film is digitized with a film scanner and histopathologic slides are digitized using a red, green, and blue (RGB) video camera connected to a microscope. Digitized images are stored on a data server connected to the institution's computer communication network (Ethernet) and can be displayed from authorized desktop computers connected to Ethernet. Images are digitized for cases presented at the Bone Tumor Management Conference, a multidisciplinary conference in which treatment options are discussed among clinicians, surgeons, radiologists, pathologists, radiotherapists, and medical oncologists. These radiographic and histologic images are shown on a large screen computer monitor during the conference. They are available for later review for follow-up or representation.

Clinical Laboratory Information Systems↗
PubMed1994

Hospital-wide PACS with a digital image intensifier TV system.

Tokyo Hitachi Hospital, Hitachi Ltd., has used a hospital-wide PACS for over 1 year. The system runs a 100 Mb/s optical fiber network over the whole hospital including wards and outpatient clinic rooms, with 11 image workstations. The network links digital imaging modalities such as X-CT, MRI, computed radiography (CR) and digital radiography (DR) with a 2048 x 2048 (2k x 2k) matrix image intensifier television (I.I.-TV) system. These modalities generate about 200 images/day. The system has managed over 300,000 images of about 8000 patients so far. Although being still under improvement, the system has really been used for routine work. The hospital-wide PACS of a small hospital has been proved to be very useful for both image diagnosis and image management.

Computer Terminals↗
PubMed2005

[Experience with electronic files in a university neonatology unit].

The electronic file is a reality in medical practice nowadays. We have a decade of experience with electronic files in a neonatology unit. We use a local network that consists in one server and 8 connected computers, distributed in the hospital. Filemaker Pro is used as database administrator and access to data is protected with passwords. Data entry is made by health care professionals in charge of the patients. Patient's reports and statistical information are based on data entered to the system. This methodology allows to have update clinical data, indexing of information, to maintain track of pharmacological indications, prescribe parenteral nutrition and obtain information for research purpose. It is possible therefore, with a minimal computing expertise, to devise electronic files that can improve the quality of health care.

Abstracting and Indexing↗
PubMed1999

The Decim system for the production of dental restorations.

The general background to the development of CAD/CAM is presented in short. Specific problems when using this technique for the manufacturing of dental restorations are emphasized, and then the reverse engineering and CAD/CAM process that have been implemented in the Decim (Dentronic AB, Skellefteå, Sweden) system are presented. The system is organized in the following way: 1. The measurement process is encapsulated in a product called Decim Reader. 2. The design functionality is provided by software running on a conventional personal computer. This unit is called Decim Designer. 3. The CAM calculation is done by a dedicated personal computer, the Decim Calculator, that does not require any user interaction. 4. The actual manufacturing of the restorations is performed in the Decim Producer that works with a grinding technique. These components communicate via a local computer network or, when a distributed solution is desired, via internet. The Decim System is presently used for the production of dental ceramic restorations, and it is the only system which can be used for manufacturing inlays of yttria-stabilized zirconia. This ceramic material is CE-approved under the brand name Denzir (Dentronic AB, Skellefteå, Sweden). Due to its favorable mechanical properties, it may be an alternative to dental amalgam, and is therefore of topical interest in dentistry. The use of computer-based techniques for manufacturing dental restorations is briefly outlined and commented on.

Ceramics↗
PubMed1998

Computerization in breast imaging and diagnosis.

Computerization in breast imaging is very important for activity management and for the qualitative and quantitative control of the diagnoses. The connection through a personal computer network is necessary for the simultaneous input of more data. The activity in our center is completely managed by a specific software which controls and facilitates the input of all personal, administrative, history, instrumental and pathological data. The encoded case history permits quick and accurate data input and the relative information is easy to understand. Database information can be used to make periodical administrative and diagnostic reports and queries, to elaborate useful data for scientific reports and to manage didactic material. The growing use of computers will permit the exchange of data among breast imaging centers and also create important data banks for breast cancer studies.

Ambulatory Care Information Systems↗
PubMed1991

Implementing a clinical information system.

The design of CIS utilizing the hospital's network allows for the flexibility of providing clinicians with on-line access to additional valuable patient information. The acceptance of CIS and the continuing demand for access to CIS are excellent indicators that development of this system was well worth the efforts of the individuals and teams involved in the planning, design, and implementation of CIS. Although it cannot replace the traditional paper medical record, CIS certainly is being recognized as a timely and reliable resource for the communication of patient information in the Ohio State University's numerous patient treatment facilities.

Clinical Medicine↗
PubMed1992

A computerized intensive care unit order-writing protocol.

OBJECTIVE: To present a computerized intensive care unit order-writing protocol. DESIGN: Descriptive report. SETTING: Eight-bed surgical intensive care unit, Department of Surgery, Department of Veterans Affairs Medical Center, Bronx, NY. METHODS: IBM-based, computer network program that provides user-friendly, logical, and comprehensive organ-system order sequences for patient management. RESULTS: Since July 1988, an order program that stresses (1) improved and more efficient patient care, (2) the use of program-integrated automatic safety features, (3) the substitution of computer entry for handwriting, and (4) the assurance that physicians deliver obligatory care in a logical organ-system-based progression has been implemented. CONCLUSIONS: The order protocol system presented is simple to introduce and operate, has minimal training and technical requirements, and is demonstrably reliable.

Computer Security↗
PubMed1997

High-performance computing and networking as tools for accurate emission computed tomography reconstruction.

It is well known that the quantitative potential of emission computed tomography (ECT) relies on the ability to compensate for resolution, attenuation and scatter effects. Reconstruction algorithms which are able to take these effects into account are highly demanding in terms of computing resources. The reported work aimed to investigate the use of a parallel high-performance computing platform for ECT reconstruction taking into account an accurate model of the acquisition of single-photon emission tomographic (SPET) data. An iterative algorithm with an accurate model of the variable system response was ported on the MIMD (Multiple Instruction Multiple Data) parallel architecture of a 64-node Cray T3D massively parallel computer. The system was organized to make it easily accessible even from low-cost PC-based workstations through standard TCP/IP networking. A complete brain study of 30 (64x64) slices could be reconstructed from a set of 90 (64x64) projections with ten iterations of the conjugate gradients algorithm in 9 s, corresponding to an actual speed-up factor of 135. This work demonstrated the possibility of exploiting remote high-performance computing and networking resources from hospital sites by means of low-cost workstations using standard communication protocols without particular problems for routine use. The achievable speed-up factors allow the assessment of the clinical benefit of advanced reconstruction techniques which require a heavy computational burden for the compensation effects such as variable spatial resolution, scatter and attenuation. The possibility of using the same software on the same hardware platform with data acquired in different laboratories with various kinds of SPET instrumentation is appealing for software quality control and for the evaluation of the clinical impact of the reconstruction methods.

Algorithms↗
PubMedDate not supplied

Intranet-based multi-purpose medical records in orthopaedics.

Quality assurance in orthopaedics--as in any medical speciality--relies on precise medical records. Data quality is crucial for statistical evaluation; missing values cannot be avoided but must be minimized. The quality assurance system must be accessible from many locations within the clinic; given the complex and heterogeneous computing infrastructure this is a technological challenge. Intranet technology--the application of internet-tools in local networks--can help to solve the technical problems. A generic Intranet-based quality assurance system in orthopaedics was designed, implemented and evaluated. The basic concept is an intranet data entry form which is generated semi-automatically from the data definition. This form is adapted according to the individual needs of the doctors (intelligent data entry). By flexible data transformation the same data set is used for clinical reports as well as scientific evaluations. The first use was for ultrasound examinations of neonatal hips. A report form consisting of 56 items was designed. Within the first 9-month period 1303 cases have been documented.

Attitude of Health Personnel↗
PubMed1996

A Clinical Informatics Network (CLINT) to support the practice of evidence-based health care.

CLINT, which stands for Clinical Informatics NeTwork, is one of the clinical informatics initiatives in development at McMaster University's Health Information Research Unit. CLINT is a microcomputer-based system of over 60 workstations providing 24 hour availability of a set of clinical information resources to clinicians throughout our teaching hospital. CLINT encompasses three domains: (1) a user adaptable clinician-computer interface, (2) unique evidence-based health care content, and (3) automated data collection and viewing tools. An objective of the CLINT project is to determine CLINT's impact on the practice of health care. Early analysis of our data has revealed that over the past year, there has been widespread use of CLINT by clinicians from all clinical domains. Our next task is to evaluate CLINT's usefulness.

Clinical Medicine↗
PubMed1997

An image capture and communication system for emergency computed tomography.

An image capture and communication system for emergency computed tomography (CT) is presented. The system, named ICCS, integrates CT scanners, personal computers (PC), network systems, an IBM API gateway and an IBM mainframe platform. The ICCS was implemented in the emergency unit in the Taichung Veterans General Hospital (TCVGH) and has received considerable support from the doctors, nurses and staff of the TCVGH emergency unit who have shown great interest in ICCS. This is because ICCS allows physicians in the emergency unit to examine patients' images on image viewing stations immediately after the patients are CT scanned. It also makes remote consultation possible for doctors who can stay where they are and consult with radiologists through the system and a hot line without leaving the emergency unit. This advantage greatly reduces the consultation time and saves many unnecessary trips between the emergency unit and the Department of Radiology.

Emergency Service, Hospital↗
PubMedDate not supplied

Document imaging and the patient chart: envisioning the future for your practice.

This plan for computerizing the dental patient record is designed to be implemented in a stepwise fashion. It assumes a fully developed and well accepted practice management system is already present in the business office to ensure organizational readiness and a culture embracing technology and its accompanying changes. Electronic claims submission is implemented next to not only realize the competitive advantages of EDI in the dental office; but also, to introduce the process of multi-user communication. Electronic charting in the dental operatory is first implemented as a stand alone system. This allows users to understand the new workflow requirements and oral exam redesign when a computer is introduced in the treatment room. The dental team must understand that the ultimate goal of this plan is to network the entire system and enhance communication both within and external to the dental office. No specific time requirements were given for this plan because of the variability from office to office. People need time to develop awareness, prepare for, and become skilled in using new technology. Financial constraints may also limit the speed at which the plan can be implemented. Finally, individuals in the practice must work together as a team to assess the practice's level of acceptance and ability at each step in the process. Modification will be necessary along the way as technology is constantly changing. This is a significant paradigm shift, considering that many pieces of equipment purchased for the dental office can last the dentist's entire career. This plan allows for alteration, encourages team involvement and requires a long-term strategic vision for information technology's role in the dental office.

Confidentiality↗
PubMedDate not supplied

[Respective prevalences and frequencies of Horton's disease and rhizomelic pseudopolyarthritis. Epidemiological study in the Loire-Atlantic department using a general practice research network (RESOMED 44)].

Using a research network of general practitioners (Resomed 44) representing the 20th of all GP's in the Loire Atlantique region and distributed at random according to district, age and sex made it possible to evaluate the respective prevalences of temporal arteritis (TA) and polymyalgia rheumatica (PMR) in all the systemic immune diseases listed. Among these diseases, rheumatoid arthritis was the most frequent (35.39%). TA (18.8%) and PMR (18.54%) had about the same prevalence. For each of these diseases the year/physician prevalence was evaluated at 0.11, which means that the probability for each GP to see 1 TA and 1 RP at once in 10 years. At the time of the survey, 52.9% of TA patients and 78.8% of PMR patients were surviving. GP's alone follow up more TA's and PMR's than the other systemic immune diseases.

Aftercare↗
PubMed2005

Low-power hybrid wireless network for monitoring infant incubators.

We have created a pilot wireless network for the convenient monitoring of temperature and humidity of infant incubators. This system combines infrared and radio frequency (RF) communication in order to minimize the power consumption of slave devices, and we therefore call it a hybrid wireless network. The slave module installed in the infant incubator receives the calling signal from the host with an infrared receiver, and sends temperature and humidity data to the host with an RF transmitter. The power consumption of the host system is not critical, and hence it uses the maximum power of infrared transmission and continuously operating RF receiver. In our test implementation, we included four slave devices. The PC calls each slave device every second and then waits for 6 s, resulting in a total scan period of 10 s. Slave devices receive the calling signals and transmit three data values (temperature, moisture, and skin temperature); their power demand is 1 mW, and can run for about 1000 h on four AA-size nickel-hydride batteries.

Electric Power Supplies↗
PubMed1999

Telemedicine technology and applications for home hemodialysis.

Home hemodialysis (HD) for the treatment of patients with end-stage renal disease (ESRD) was first put into practice about 30 years ago. In this paper we describe the application of telematics monitoring services (TMS) for supporting patients who need home or satellite HD (SHD). For the clinical trials two modified HD machines were located in the renal unit and a central control station (UNIX workstation with multimedia PC-terminal) was located in another room of the hospital. Bi-directional communication between modified HD machines and central control station was managed via ISDN (Integrated Services Digital Network) links. Using these HD-machines 150 HD sessions were performed in nine patients over a period of five months. This system enabled on-line remote supervision of the HD machine-related functions (air in the blood, leak of blood, low conductivity etc.) and the clinical condition of patients through measurement of blood pressure (BP), pulse rate, PO2 (pulse oxymetry) and electrocardiogram (ECG) from the central control station (CCS). The user checked the type of alarm/warning, its appearance on HD machines and multimedia terminal units (MTU), the action of the protective system and the appearance of consultative messages from CCS on the remote terminal unit RTU. According to the data collected, the disturbances of HD machine function were visible and audible in the CCS and the user messages were always observed on the RTU. No unusual dialysis-associated complications were observed, all data and alarms/warnings were transmitted correctly and patients had adequate HD treatment.

Female↗
PubMedDate not supplied

Health and welfare data on optical memory cards in Isehara city.

An off-line network system of health and welfare for elderly people using optical memory cards has been established in Isehara city (Japan) since 1991. 2775 citizens have the cards and 24 offices have the terminals. It covers almost one third of people aged over 65 in Isehara city and almost all of the offices concerned with their health and welfare. About a half of holders use optical memory cards every time they visit these offices. The optical memory card holds data including basic data for health and welfare, health check data over 5 years, medical images with scripts and history of welfare services. All the data are used for medical care, health consultation and management of health and welfare services. A card can hold health and welfare data for a lifetime, and it is easy to expand the system. It has been a good experience for us, because the optical memory card system needs co-operation among citizens, medical association and local government, and the experience will help us to expand the system in the future.

Aged↗