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PubMedDate not supplied

WIRM: an open source toolkit for building biomedical web applications.

This article describes an innovative software toolkit that allows the creation of web applications that facilitate the acquisition, integration, and dissemination of multimedia biomedical data over the web, thereby reducing the cost of knowledge sharing. There is a lack of high-level web application development tools suitable for use by researchers, clinicians, and educators who are not skilled programmers. Our Web Interfacing Repository Manager (WIRM) is a software toolkit that reduces the complexity of building custom biomedical web applications. WIRM's visual modeling tools enable domain experts to describe the structure of their knowledge, from which WIRM automatically generates full-featured, customizable content management systems.

Anatomy↗
PubMed1995

Expert systems in the health administration curriculum.

With the growing use of computers and on-line hospital information systems, a need exists for health care managers trained in computing and computer applications. This article reviews the advances in health care computing and reports on the design and implementation of a new course in a specific computer application, known as expert systems, in a health administration curriculum. The specific course framework is described and several student projects are presented and discussed.

Computer Communication Networks↗
PubMed1994

The evolution of case-mix measurement using DRGs: past, present and future.

The Diagnosis Related Groups patient classification scheme has been evolving for over twenty years. The wide variety of DRG applications in the U.S. has resulted in the development of three major versions of DRGs. The alternative DRG systems are described and compared. Comparative statistical data for each DRG system are presented.

Cost Control↗
PubMed2006

Context-aware workflow management of mobile health applications.

We propose a medical application management architecture that allows medical (IT) experts readily designing, developing and deploying context-aware mobile health (m-health) applications or services. In particular, we elaborate on how our application workflow management architecture enables chaining, coordinating, composing, and adapting context-sensitive medical application components such that critical Quality of Service (QoS) and Quality of Context (QoC) requirements typical for m-health applications or services can be met. This functional architectural support requires learning modules for distilling application-critical selection of attention and anticipation models. These models will help medical experts constructing and adjusting on-the-fly m-health application workflows and workflow strategies. We illustrate our context-aware workflow management paradigm for a m-health data delivery problem, in which optimal communication network configurations have to be determined.

Computer Communication Networks↗
PubMed2003

A wireless mobile health-related quality of life assessment.

Self-administered waiting room questionnaires are popular tools for gathering health information from patients, but they require optical scanning or manual data entry to obtain survey results. The application described here eliminates those extra steps by inputting the results into a remote database directly through wireless connection, and the assessment can be finished easily anywhere in the clinic through a mobile platform. A measure of health-related quality of life, the SF-8 Health Survey, was used in developing this application for using in the clinical setting. It has only eight questions measuring each of the eight domains of health in the longer SF-36 Health Survey.

Computer Communication Networks↗
PubMed2005

Using a context-aware medical application to address information needs for extubation decisions.

Information overload has been one of the causes of preventable medical errors [1] and escalating costs [2]. A context-aware application with embedded clinical knowledge is proposed to provide practitioners with the appropriate amount of information and content. We developed a prototype of a context-aware medical application to address clinicians' information needs that arise in a data intensive unit, the Cardio-Thoracic Intensive Care Unit (CTICU). A major clinical decision supported by the prototype, the extubation decision, is illustrated.

Decision Making, Computer-Assisted↗
PubMed1999

AnatomyBrowser: A novel approach to visualization and integration of medical information.

In this article, we present a novel technique for visualization of three-dimensional (3D) surface models, as well as its implementation in a system called AnatomyBrowser. Using our approach, visualization of 3D surface models is performed in two separate steps: a pre-rendering step, in which the models are rendered and saved in a special format, and an actual display step, in which the final result of rendering is generated using information from the prerendering step. Whereas prerendering requires high-end graphics hardware, the final image generation and display can be implemented efficiently in software. Moreover, our current implementation of AnatomyBrowser interface uses the Java programming language and can therefore be readily run on a wide range of systems, including low-end computers with no special graphics hardware. In addition to visualization of 3D models and 2D slices, AnatomyBrowser provides a rich set of annotation and cross-referencing capabilities. We demonstrate several possible applications for AnatomyBrowser, including interactive anatomy atlases, surgery planning, and assistance in segmentation.

Anatomy↗
PubMed2001

Ngi and Internet2: accelerating the creation of tomorrow's internet.

Internet2 is a consortium of leading U.S. universities working in partnership with industry and the U.S. government's Next Generation Internet (NGI) initiative to develop a faster, more reliable Internet for research and education including enhanced, high-performance networking services and the advanced applications that are enabled by those services [1]. By facilitating and coordinating the development, deployment, operation, and technology transfer of advanced, network-based applications and network services, Internet2 and NGI are working together to fundamentally change the way scientists, engineers, clinicians, and others work together. [http://www.internet2.edu] The NGI Program has three tracks: research, network testbeds, and applications. The aim of the research track is to promote experimentation with the next generation of network technologies. The network testbed track aims to develop next generation network testbeds to connect universities and federal research institutions at speeds that are sufficient to demonstrate new technologies and support future research. The aim of the applications track is to demonstrate new applications, enabled by the NGI networks, to meet important national goals and missions [2]. [http://www.ngi.gov/] The Internet2/NGI backbone networks, Abilene and vBNS (very high performance Backbone Network Service), provide the basis of collaboration and development for a new breed of advanced medical applications. Academic medical centers leverage the resources available throughout the Internet2 high-performance networking community for high-capacity broadband and selectable quality of service to make effective use of national repositories. The Internet2 Health Sciences Initiative enables a new generation of emerging medical applications whose architecture and development have been restricted by or are beyond the constraints of traditional Internet environments. These initiatives facilitate a variety of activities to foster the development and deployment of emerging applications that meet the requirements of clinical practice, medical and related biological research, education, and medical awareness throughout the public sector. Medical applications that work with high performance networks and supercomputing capabilities offer exciting new solutions for the medical industry. Internet2 and NGI,strive to combine the expertise of their constituents to establish a distributed knowledge system for achieving innovation in research, teaching, learning, and clinical care.

Internet↗
PubMed2004

The impact of ICT on communication in healthcare.

Communication processes are pervasive in the daily practice of health professionals. Reorganizing these daily practices by introducing ICT, inevitably effects one or more communication processes. Understanding exactly what these effects are, is a major problem in designing and implementing ICT-applications. In this paper we present an analysis of these effects, based on a theory of communication processes. The concept of 'decoupling' is pivotal in our analysis. Based on the identified effects, and some preconditions that have to be met in order for these effects to take place, we derive a number of guidelines for reorganizing communication processes by means of applying ICT. The application of these guidelines will be demonstrated and discussed in the context of the reorganization of a team conference at the Rehabilitation Clinic of the Rheumatology Department of the Leiden University Medical Center (RCRD/LUMC).

Information Theory↗
PubMed1995

Primary care guidelines from an organizational point of view.

Guidelines in primary health care have been developed to reduce assumed and undesired variation in certain aspects of care delivery by professionals. If systematically applied guidelines no doubt effect the quality of care. It is argued however that taking an organizational point of view on quality management yields new requirements with respect to development and application of guidelines. It is considered to be essential for managerial control purposes that guidelines have simple and valid indicators to monitor the actual application and to measure the preferred outcome. It is essential that the choice of guidelines to be implemented in an organization is determined in the context of an explicit plan for quality management.

Humans↗
PubMed1999

The telemedicine and second medical opinion.

Telemedicine is declared as delivery of care to patients anywhere in the world by combining communications technology, with medical expertise. The well established applications of telemedicine are in the field of teleradiology, pathology, cardiology. In some cases video-conferencing (VC) may be applied. Second medical opinion is an important additional viewpoint on the patient diagnosis and treatment. The established network of consultant hospitals and worldwide Second opinion centers enable a fast (24-72 hours response) second medical opinion consultation service with the telemedicine application. The consultant hospitals at present time are: UCSF--San Franscisco, Stanford Medical Center, Bowman Gray School of Medicine, The Brigham Radiology Foundation, Emory University Hospital, University of Pennsylvania Medical Center. The second opinion centers are located worldwide, just to mention some of them: London, Budapest, Ljubljana, Tel Aviv, Bombay, Athens, Milano, Seoul.

Humans↗
PubMed2005

Health. Care. Anywhere. Today.

What if clinical quality medical equipment were available to every consumer in a form factor that was inexpensive, accurate, and easy to use? What if this equipment provided information that previously was un-measurable or very difficult to measure? What if the physiological state of individuals, at resolutions measured in thousandths of a second instead of in visits per year, could be measured easily, making it possible to ascertain caloric intake and expenditure, patterns of sleep, contextual activities such as working-out and driving, even parameters of mental state and health. What aspect of healthcare would not change? We present a system that is available today that enables this vision. This award-winning multi-channel wearable physiological monitor has enabled the collection of more than 90 million minutes of data in natural settings from thousands of subjects engaged in diverse activities. Data modeling efforts are resulting in applications that present meaningful and actionable information in real-time to users and their designated collaborators (physicians, family members, counselors, coaches, etc.) We describe the SenseWear system, its design, and a summary of validation studies, current commercial applications, and ongoing research. This discussion will show how the convergence of design for wearability, advances in machine learning, and improvements in wireless technology will manifest the future of health care as personal, ubiquitous, and collaborative.

Clothing↗
PubMed2005

Evolving telemedicine/ehealth technology.

This paper describes emerging technologies to support a rapidly changing and expanding scope of telemedicine/telehealth applications. Of primary interest here are wireless systems, emerging broadband, nanotechnology, intelligent agent applications, and grid computing. More specifically, the paper describes the changes underway in wireless designs aimed at enhancing security; some of the current work involving the development of nanotechnology applications and research into the use of intelligent agents/artificial intelligence technology to establish what are termed "Knowbots"; and a sampling of the use of Web services, such as grid computing capabilities, to support medical applications. In addition, the expansion of these technologies and the need for cost containment to sustain future health care for an increasingly mobile and aging population is discussed.

Algorithms↗
PubMed2005

Knowledge logistics as an intelligent service for healthcare.

OBJECTIVES: The technology of grid services is developing fast. This paper presents an approach to the implementation of an intelligent grid service that configures a hospital taking advantage of the knowledge logistics idea. METHODS: The presented approach is based on synergistic integration of knowledge acquired from distributed sources in order to obtain new or complement insufficient knowledge. Presented approach uses ontologies and the formalism of object-oriented constraint networks for knowledge representation and applies ILOG to constraint-based problem solving. RESULTS: The application of the approach is illustrated via a decision support system for a fictitious case study of a hospital configuration in the Binni region. The system showed the ability to produce interrelated solutions for subtasks of the hospital configuration task based on the built ontology and input parameters. Besides, such preferences as cost or time minimization are also considered by the implemented fuzzy logic module that finds a feasible solution. CONCLUSIONS: KL would benefit from the grid, and particularly from the concept of a semantic grid. The scalable architecture of the approach enables its extension with regard to knowledge/information sources number and, thereby, with regard to factors taken into account during complex problem solving. Utilizing ontologies allows integration of the approach into existing processes and facilitates knowledge sharing with similar systems. Application of constraint networks allows rapid problem manipulation and usage of such existing efficient technologies as ILOG.

Artificial Intelligence↗
PubMed1995

[Validation of a computer-assisted procedure for producing blood and blood component transfusions].

BACKGROUND: The validation of computer-aided methods in the production of stored blood and blood components represents for a pharmaceutical institution a basic condition for the carrying out of the decrees of pharmaceutical companies. When validating computer-aided methods in medicine or pharmacy, the fields of informatics and technology have to be linked to applications in medicine and pharmacy. METHOD: In many cases the methods for the documented proof that a system achieves the expected capacity are too complex, so that a validation is only practicable in module groups. This is shown with an example of the blood typing on microtiter plates. RESULTS: After the selection of the hard- and software according to the safety criteria of information technology taking into consideration functional classes and degrees of quality, a complete documentation of the validation of blood typing on the microtiter plate was carried out.

Blood Banks↗
PubMed1998

Review of biomedical knowledge and data representation with conceptual graphs.

The basis of conceptual graphs theory is an ontology of types of concepts. Concepts issued from the ontology are interlinked by semantic relationships and constitute canonical conceptual graphs. Canonical graphs may be combined to derive new conceptual graphs by means of formation rules. This formalism allows to separate knowledge representation into a conceptual level and a domain-dependent level, and enables to share and reuse a representation. This paper presents conceptual graph applications to biomedical data and concept representation, classification systems, information retrieval, and natural language understanding and processing. A discussion on the unifying role conceptual graphs theory plays in the implementation of knowledge-based systems is also presented.

Artificial Intelligence↗
PubMed2004

The impact of structuring multidisciplinary team conferences mediated by ICT in the treatment of patients with rheumatic diseases.

Communication processes are pervasive in the daily practice of health professionals. Reorganizing these daily practices by introducing ICT, inevitably effects one or more communication processes. Understanding exactly what these effects are, is a major problem in designing and implementing ICT-applications. In this paper we present an analysis of these effects, based on a theory of communication processes. The concept of 'decoupling' is pivotal in our analysis. Based on the identified effects, and some preconditions that have to be met in order for these effects to take place, we derive a number of guidelines for reorganizing communication processes by means of applying ICT. The application of these quidelines will be demonstrated and discussed in the context of the reorganization of a team conference at the Rehabilitation Clinic of the Rheumatology Department of the Leiden University Medical Center (RCRD/LUMC), a multidisciplinary team care setting.

Health Personnel↗
PubMed2003

Bayesian machine learning and its potential applications to the genomic study of oral oncology.

With the completion of the Human Genome Project and the growing computational challenges presented by the large amount of genomic data available today, machine learning is becoming an integral part of biomedical research and plays a major role in the emerging fields of bioinformatics and computational biology. This situation offers unparalleled opportunities and unprecedented challenges to machine learning research in general and to Bayesian learning methods in particular. This paper outlines some of the opportunities and the challenges of this endeavor, it describes where the efforts of "cracking the code of life" can most benefit from a Bayesian approach, and it identifies some potential applications of Bayesian machine learning methods to the genomic analysis of squamous cell carcinomas of the head and neck.

Bayes Theorem↗