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PubMed1997

Dermatology and the World Wide Web.

The internet is a global network of computer databases. Over the last decade the fastest growing area of the internet has been the World Wide Web. The World Wide Web now offers a vast array of dermatologic resources that can be used to support the delivery of patient care. The purpose of this article is to provide a brief explanation of the World Wide Web, and to list some of the dermatologic resources that are available there.

Computer Communication Networks↗
PubMed1998

Enterprise-scale image distribution with a Web PACS.

The integration of images with existing and new health care information systems poses a number of challenges in a multi-facility network: image distribution to clinicians; making DICOM image headers consistent across information systems; and integration of teleradiology into PACS. A novel, Web-based enterprise PACS architecture introduced at Massachusetts General Hospital provides a solution. Four AMICAS Web/Intranet Image Servers were installed as the default DICOM destination of 10 digital modalities. A fifth AMICAS receives teleradiology studies via the Internet. Each AMICAS includes: a Java-based interface to the IDXrad radiology information system (RIS), a DICOM autorouter to tape-library archives and to the Agfa PACS, a wavelet image compressor/decompressor that preserves compatibility with DICOM workstations, a Web server to distribute images throughout the enterprise, and an extensible interface which permits links between other HIS and AMICAS. Using wavelet compression and Internet standards as its native formats, AMICAS creates a bridge to the DICOM networks of remote imaging centers via the Internet. This teleradiology capability is integrated into the DICOM network and the PACS thereby eliminating the need for special teleradiology workstations. AMICAS has been installed at MGH since March of 1997. During that time, it has been a reliable component of the evolving digital image distribution system. As a result, the recently renovated neurosurgical ICU will be filmless and use only AMICAS workstations for mission-critical patient care.

Computer Communication Networks↗
PubMedDate not supplied

Network and data security design for telemedicine applications.

The maturing of telecommunication technologies has ushered in a whole new era of applications and services in the health care environment. Teleworking, teleconsultation, mutlimedia conferencing and medical data distribution are rapidly becoming commonplace in clinical practice. As a result, a set of problems arises, concerning data confidentiality and integrity. Public computer networks, such as the emerging ISDN technology, are vulnerable to eavesdropping. Therefore it is important for telemedicine applications to employ end-to-end encryption mechanisms securing the data channel from unauthorized access of modification. We propose a network access and encryption system that is both economical and easily implemented for integration in developing or existing applications, using well-known and thoroughly tested encryption algorithms. Public-key cryptography is used for session-key exchange, while symmetric algorithms are used for bulk encryption. Mechanisms for session-key generation and exchange are also provided.

Algorithms↗
PubMed1995

Administrative and security challenges with electronic patient record systems.

EPRS security is clearly an area of concern to all health information management professionals. With the advent of enterprise-wide linkages, as well as community health information networks (CHINs) and other remote linkages, security is a critical issue that must be addressed in detail during system selection and implementation. Strict enforcement of security policies and procedures is mandatory. Technology has given health information management professionals the tools to secure the patient record. Use of these tools is required to meet the challenges presented by the transition to the electronic realm.

Authorship↗
PubMed1999

Java-based framework for the secure distribution of electronic medical records.

In this paper, we present a Java-based framework for the processing, storage and delivery of Electronic Medical Records (EMR). The choice of Java as a developmental and operational environment ensures operability over a wide-range of client-side platforms, with our on-going work emphasising migration towards Extensible Markup Language (XML) capable Web browser clients. Telemedicine in support of womb-to-tomb healthcare as articulated by the Multimedia Supercorridor (MSC) Telemedicine initiative--which motivated this project--will require high-volume data exchange over an insecure public-access Wide Area Network (WAN), thereby requiring a hybrid cryptosystem with both symmetric and asymmetric components. Our prototype framework features a pre-transaction authentication and key negotiation sequence which can be readily modified for client-side environments ranging from Web browsers without local storage capability to workstations with serial connectivity to a tamper-proof device, and also for point-to-multipoint transaction processes.

Computer Communication Networks↗
PubMed1996

The "SentiWeb" method for exploring a database on the Net.

Return of information is one of the main goals of any public health information system. About 25,000 maps and 10,000 graphs may be obtained from the time-series collected in the database of the French Communicable Diseases Network (FCDN). Furthermore, this huge epidemiological atlas is updated each week. What is the optimal way of returning such information? This report discloses the strategies used for enhancing the access facilities to the FCDN database for any users, particularly those without specific training in epidemiology or database query language. The technical options implemented in the SentiWeb server (http:/(/)www.b3e.jussieu.fr) are discussed.

Communicable Diseases↗
PubMedDate not supplied

Lossy compression techniques, medical images, and the clinician.

There has been increasing interest in the storage and retrieval of medical images in hospitals and clinics here in Brazil and elsewhere. At the Heart Institute of São Paulo, with thousands of image-based procedures performed each month, the pursuit of optimal transmission and storage methods for digital images is a major concern. The use of data-compression techniques can reduce the enormous amount of imaging data to be stored or transmitted across a computer network, so that the efficiency of the computing system is preserved. The techniques for image compression can be categorized as "lossless" or "lossy," with "lossy" techniques being those in which some, supposedly irrelevant information is lost. Lossy techniques are much more efficient than lossless ones, achieving data-compression ratios as high as 100:1.

Algorithms↗
PubMed1992

Protecting the privacy of patient information in clinical networks: regulatory effectiveness analysis.

Patient privacy is one of the major issues in the development of modern clinical information system networks. Such networks will have to demonstrate an appropriate concern for privacy as a precondition of operation. Regulatory effectiveness analysis is a novel technique for measuring compliance with a technological regulatory system. By examining the public policies, legal structures, and technical tools involved in the regulatory system, it is possible to discover discontinuities that may result in noncompliance with the regulatory system.

Civil Rights↗
PubMed2006

Multiperiod cellular network design via price-influenced simulated annealing (PISA).

Cellular telecommunications systems tend to be more flexible than traditional ones. As a result, traditional approaches to telecommunications network design are often inappropriate for the design of cellular networks, and approaches that explicitly incorporate the increased flexibility into the design process need to be developed. This paper presents one such multiperiod cellular network design problem and solves it via a hybrid heuristic that incorporates ideas from linear programming (LP) and simulated annealing (SA). Extensive computational results comparing the performance of the heuristic with the lower bound obtained from the LP relaxation are presented. These results indicate that this price-influenced simulated annealing (PISA) procedure is extremely efficient, consistently providing solutions with average gaps of 0.30% or less in fewer than 30 s.

Cell Phone↗
PubMed1999

Meta-manager: a requirements analysis.

The digital imaging network-picture-archiving and communications system (DIN-PACS) will be implemented in ten sites within the Great Plains Regional Medical Command (GPRMC). This network of PACS and teleradiology technology over a shared T1 network has opened the door for round the clock radiology coverage of all sites. However, the concept of a virtual radiology environment poses new issues for military medicine. A new workflow management system must be developed. This workflow management system will allow us to efficiently resolve these issues including quality of care, availability, severe capitation, and quality of the workforce. The design process of this management system must employ existing technology, operate over various telecommunication networks and protocols, be independent of platform operating systems, be flexible and scaleable, and involve the end user at the outset in the design process for which it is developed. Using the unified modeling language (UML), the specifications for this new business management system were created in concert between the University of Arizona and the GPRMC. These specifications detail a management system operating through a common object request brokered architecture (CORBA) environment. In this presentation, we characterize the Meta-Manager management system including aspects of intelligence, interfacility routing, fail-safe operations, and expected improvements in patient care and efficiency.

Arizona↗
PubMed1999

Process mapping in screening mammography.

Successful screening mammography programs aim to screen large numbers of women efficiently and inexpensively. Development of an effective screening mammography program requires skilled personnel, solid infrastructure, and a robust computer system. A group of physicians, technologists, computer support personnel, and administrators carefully analyzed a growing screening mammography program as a series of steps, starting with the request for the examination and ending with the receipt of a hard-copy consultation. The analysis involved a detailed examination of every step and every possible outcome in the screening process. The information gained through process mapping may be used for identification of systemic and personnel problems, allocation of resources, modification of workplace architecture, and design of computer networks. Process mapping is helpful for those involved in designing and improving screening mammography programs. Viewing a process (i.e., obtaining a screening mammogram) as a series of steps may allow for the identification of inefficient components that may limit growth.

Adult↗
PubMed1997

A comprehensive knowledge-based system for laboratory hematology.

The Coulter FACULTY knowledge-based systems, Professor Petrushka for peripheral blood interpretation, Professor Fidelio for flow cytometry immunophenotyping and Professor Belmonte for bone marrow reporting, have been installed in several hospitals in Spain, Portugal and the United Kingdom. In Spain and Portugal, the systems are part of the IZASA-Coulter CITOTECA workstation, which includes a video camera for capturing microscopic images and a networkable laboratory information system supporting color reports. At the Royal Hospitals Trust (St. Bartholomew's Hospital and The Royal London Hospital, London, UK), networked workstations are available and the system is used daily to generate bone marrow reports in the hematology laboratories. There have been considerable benefits from adopting Coulter FACULTY for bone marrow reporting, including faster turnaround time, improved quality of the reports and cost savings.

Artificial Intelligence↗
PubMed2000

Computers and caregiving: reaching out and redesigning interventions for homebound older adults and caregivers.

This article discusses computer resources for homebound older adults and informal caregivers as an intervention to promote social support and mental health. Published information related to a computer network designed as an intervention for informal caregivers of persons with Alzheimer's disease is included. This information suggests that homebound older adults and informal caregivers can gain valuable information, confidence, and support by using computer resources. A review of the literature supported those findings and suggested that computer technology can facilitate continuing education and the refinement of skills for nurses. Implications for the use of computer resources in nursing education, practice, and research are presented.

Aged↗
PubMed2001

TeleMedMail: free software to facilitate telemedicine in developing countries.

Telemedicine offers the potential to alleviate the severe shortage of medical specialists in developing countries. However lack of equipment and poor network connections usually rule out video-conferencing systems. This paper describes a software application to facilitate store-and-forward telemedicine by email of images from digital cameras. TeleMedMail is written in Java and allows structured text entry, image processing, image and data compression, and data encryption. The design, implementation, and initial evaluation are described.

Computer Communication Networks↗
PubMed2003

[EMI net--electronic medical record sharing in local community for home care medicine].

An electronic medical information network (EMI net) includes patient records from more than 40 facilities in Matsudo City and it is now used especially to improve the communication between doctors and nurses who visit patients' home. This fact suggests the importance of a medical information sharing system in a local area for home care medicine. An infrastructure connecting facilities to share the database of the patient records is essential for home care medicine performed by a multidisciplinary team beyond one medical facility.

Community Networks↗
PubMed2003

[EMI net--electronic medical record sharing in local community for home care medicine].

An electronic medical information network (EMI net) includes patient records from more than 40 facilities in Matsudo City and it is now used especially to improve the communication between doctors and nurses who visit patients' homes. This fact suggests the importance of a medical information sharing system in a local area for home care medicine. An infrastructure connecting facilities to share the database of the patient records is essential for home care medicine performed by a multidisciplinary team beyond one medical facility.

Community Networks↗
PubMed2002

A message model designed by EDISANTE WG 11.

WG 11 is one of the Working Groups of the EDISANTE Association. First, his mission was to define message models with two parts: The envelope of the message, including a header, the characteristics of the transmitter, of the receiver, and of the patient concerned. The contents of the message, including medical data which could be exchanged between different middleware. This second part was halted by the " Réseau Santé Social", public network for all the healthcare professionals, who want to have a structured content for his "medical message format". The prupose of EDISANTE is essentially to promote the use of EDI in health care. In a second time, this association decide to include work about envelope in a larger domain concerning all exchanges in medical domains, so the GT 11 centred his action on content.

Computer Communication Networks↗
PubMed1994

Privacy and security requirements of distributed computer based patient records.

Privacy and security issues increase in complexity as we move from the conventional patient record to the computer based patient record (CPR) supporting patient care and to cross-institutional networked CPRs. The privacy and security issues surrounding the CPR are outlined. Measures for privacy and security protection are summarized. It is suggested that we lack a key component of an information sharing culture. We need means for semantic indexing in the form of a metadata base at the level of the instantiation of a data base rather than at the level of its schemas.

Computer Communication Networks↗