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At least 577 records · Page 32Linked to original sources
PubMed2005

Design of a flexible platform for execution of medical decision support agents in the intensive care unit.

This paper addresses the design of a generic and scalable platform for the execution of medical decision support agents in the intensive care unit (ICU). As will be motivated, medical decision support agents can impose high computational load and in practical setups a large amount of such agents are typically running in parallel. Future ICU systems will rely on extensive medical decision support. However, in current systems only one workstation is typically dedicated for the execution of medical decision support agents. Therefore, we propose an architecture based on middleware technology to allow for easy distribution of the agents along multiple workstations. The architecture allows for easy integration with a general ICU data flow management architecture.

Computer Security↗
PubMed2002

Application service providers in dentistry.

ASP practice management systems are a new and potentially useful service for the dental profession. ASP systems have the potential to reduce the time, effort, and expense required to maintain computer-based practice management functions. ASP systems can deliver a rich array of functions at a distance, eliminate concerns about upgrades, back-ups, and server hardware, and make management of client workstations easier. The ASP industry is young, however, and its companies and products will be in constant flux. Practitioners should exercise great caution in selecting an ASP system. If the ASP model proves viable in dentistry over the long term, we can expect to see a growing number of services being delivered over the Internet. Many ASPs exist already that serve many needs of small businesses, such as accounting, personnel management, and supply ordering. Application service provider systems also have the potential to improve communication between dental care providers. The ease of exchanging selected patient information between providers may result in more patient-related information exchange than is currently the case. The quality of dental care can only benefit.

Computer Systems↗
PubMed2002

Visually enhanced CCTV digital surveillance utilizing Intranet and Internet.

This paper describes a solution for integrated plant supervision utilizing closed circuit television (CCTV) digital surveillance. Three basic requirements are first addressed as the platform of the system, with discussion on the suitable video compression. The system configuration is described in blocks. The system provides surveillance functionality: real-time monitoring, and process analysis functionality: a troubleshooting tool. This paper describes the formulation of practical performance design for determining various encoder parameters. It also introduces image processing techniques for enhancing the original CCTV digital image to lessen the burden on operators. Some screenshots are listed for the surveillance functionality. For the process analysis, an image searching filter supported by image processing techniques is explained with screenshots. Multimedia surveillance, which is the merger with process data surveillance, or the SCADA system, is also explained.

Equipment Design↗
PubMed2001

Implementation of a dynamic platform-independent DICOM-server.

Hospital-wide image and patient data transfer within heterogeneous hard- and software infrastructures can be facilitated by using standardized communication protocols and data formats such as digital imaging and communications in medicine (DICOM). Each DICOM application entity (AE) usually provides a static and fixed set of services according to its functionality. However, certain security concepts, changing demands of medical users, or restricted hardware capabilities may be more easily addressed by applications that dynamically provide variable subsets of DICOM services. In a new approach, an object-oriented DICOM server framework was developed that served as a basis for assembling various DICOM applications. These applications may be set up dynamically to offer variable subsets of services at runtime, similar to "plug-ins". The framework was designed and implemented in Java in order to provide low-cost platform-independent solutions. As an example, a DICOM server was implemented and tested in a clinical application providing access to MR and CT images through a Java/DICOM viewer. Data retrieval was optimized by storing parts of the image acquisition and patient data into a relational database.

Computer Systems↗
PubMedDate not supplied

Development of medical information transfer system using personal-agent optical disks.

The establishment of a better local area medical centre containing hospitals and clinics is thought to be a very important issue. The medical information system, which should be accepted by both hospitals and clinics, has been studied using graphic user interface (GUI) and a three dimensional structure. Our system files medical records and blood examination data as well as diagnostic images, which may be the first attempt in the world. It has been favourably evaluated by physicians through clinical evaluation.

Evaluation Studies as Topic↗
PubMed1998

A comprehensive influenza campaign in a managed care setting.

Group Health Cooperative, a large, membership-governed, staff model health maintenance organization (HMO), has designed a comprehensive influenza campaign for identifying, recruiting and vaccinating enrollees at increased risk for influenza-related complications. The Cooperative's Centre for Health Promotion is responsible for the overall planning, implementation and evaluation of the influenza campaign. The model for delivering influenza immunizations has been designed to build on the strengths and capabilities of a staff model HMO with sophisticated automated information systems. The model permits area medical centres (AMCs) and physicians to use the materials and intervention strategies generated by the Centre for Health Promotion, while at the same time allowing them flexibility to design and use their own intervention strategies to increase compliance. More importantly, the model reduces resource requirements on AMCs and physicians to plan and maintain internal immunization efforts. Recommendations for improving the influenza campaign are discussed.

Aged↗
PubMed1999

Clinical experience with interactive teleconsultation and teleassistance in craniomaxillofacial surgical procedures.

PURPOSE: The objective of this study was to evaluate the clinical value and feasibility of surgical telenavigation and teleassistance technology in the field of craniomaxillofacial surgery. MATERIALS AND METHODS: The technology is based on the principles of augmented reality environment technology and remote stereotactic visualization. A consultant surgeon in a remote location receives video, audio, and stereotactic navigation data from the operation site almost in real-time and, using a head-mounted display, is emerged in the surgical augmented reality environment. By telepresence or teleconsultation, the composite images and superimposed graphics (instruments, target structures, landmarks, contours) can be seen and discussed in connected clinics with the possibility of interactive manipulation and assistance. RESULTS: Interactive teleassistance was used in 27 cases of various types craniomaxillofacial surgery. The principles of computer-aided telenavigation were applied successfully. Technical problems in 6 cases did not cause a breakdown of overall system performance. CONCLUSION: Teleconsultation with remote experts is a useful tool, although some shortcomings exist. The financial and personal effort involved is considerable.

Computer Graphics↗
PubMedDate not supplied

High-performance electron tomography of complex biological specimens.

We have evaluated reconstruction methods using smooth basis functions in the electron tomography of complex biological specimens. In particular, we have investigated series expansion methods, with special emphasis on parallel computation. Among the methods investigated, the component averaging techniques have proven to be most efficient and have generally shown fast convergence rates. The use of smooth basis functions provides the reconstruction algorithms with an implicit regularization mechanism, very appropriate for noisy conditions. Furthermore, we have applied high-performance computing (HPC) techniques to address the computational requirements demanded by the reconstruction of large volumes. One of the standard techniques in parallel computing, domain decomposition, has yielded an effective computational algorithm which hides the latencies due to interprocessor communication. We present comparisons with weighted back-projection (WBP), one of the standard reconstruction methods in the areas of computational demand and reconstruction quality under noisy conditions. These techniques yield better results, according to objective measures of quality, than the weighted backprojection techniques after a very few iterations. As a consequence, the combination of efficient iterative algorithms and HPC techniques has proven to be well suited to the reconstruction of large biological specimens in electron tomography, yielding solutions in reasonable computation times.

Algorithms↗
PubMed2003

The LONI Pipeline Processing Environment.

The analysis of raw data in neuroimaging has become a computationally entrenched process with many intricate steps run on increasingly larger datasets. Many software packages exist that provide either complete analyses or specific steps in an analysis. These packages often possess diverse input and output requirements, utilize different file formats, run in particular environments, and have limited abilities with certain types of data. The combination of these packages to achieve more sensitive and accurate results has become a common tactic in brain mapping studies but requires much work to ensure valid interoperation between programs. The handling, organization, and storage of intermediate data can prove difficult as well. The LONI Pipeline Processing Environment is a simple, efficient, and distributed computing solution to these problems enabling software inclusion from different laboratories in different environments. It is used here to derive a T1-weighted MRI atlas of the human brain from 452 normal young adult subjects with fully automated processing. The LONI Pipeline Processing Environment's parallel processing efficiency using an integrated client/server dataflow model was 80.9% when running the atlas generation pipeline from a PC client (Acer TravelMate 340T) on 48 dedicated server processors (Silicon Graphics Inc. Origin 3000). The environment was 97.5% efficient when the same analysis was run on eight dedicated processors.

Brain Mapping↗
PubMed1998

Development and implementation of evidence-based guidelines: a multisite demonstration project.

The development of alternative patient care delivery systems is being explored by health care providers, managed care corporations, insurance companies, and the government. Pathways, guidelines, care maps, and algorithms are techniques that assist in the development of patient care delivery systems with the potential to both decrease cost and ensure quality. This article reviews our experience with a program designed to transport clinical guidelines and pathways developed from evidence-based scientific knowledge to 7 acute care facilities located throughout the United States.

Critical Pathways↗
PubMed1998

SCP-ECG and Vital Signs Information Representation--two examples of successful transcontinental cooperation in medical informatics standardization.

During the past 2-3 decades, development work on Medical Devices focused on improving their functionality (device control, signal analysis, pattern recognition and classification). At present, the dominant user requirement is information integration. This requires interconnectivity and interoperability of devices and device systems. Today, due to all major manufacturers operating globally, this requirement can only be met if standards with global relevance are developed. The first standard discussed is the Standard Communications Protocol for Computerized Electrocardiography (SCP ECG). The rapid finalization of the standards document itself was possible due to some of the experts being involved on basic problems for greater than 10 years. Their knowledge and long standing cooperation contributed significantly to a fast consensus finding process as well as quick implementation. The second standard discussed in this paper deals with Vital Signs Information Representation. Before starting to write the document, an International inventory workshop was held to document the state of the technology and of user requirements. This common base of problem understanding makes consensus finding less difficult. Continuous cooperation between the IEEE P1073 group and the CEN/TC251 WG5 project team also ensures early harmonization of the related standards. Finally, early implementation projects in Europe and the US allow verification and modifications based on feed-back from practical experience.

Electrocardiography↗
PubMed2000

Framework for a clinical information system.

The current status of our work towards the design and implementation of a reference architecture for a Clinical Information System is presented. This architecture has been developed and implemented based on components following a strong underlying conceptual and technological model. Common Object Request Broker and n-tier technology featuring centralised and departmental clinical information systems as the back-end store for all clinical data are used. Servers located in the 'middle' tier apply the clinical (business) model and application rules to communicate with so-called 'thin client' workstations. The main characteristics are the focus on modelling and reuse of both data and business logic as there is a shift away from data and functional modelling towards object modelling. Scalability as well as adaptability to constantly changing requirements via component driven computing are the main reasons for that approach.

Appointments and Schedules↗
PubMed2004

Remote order entry and video verification: reducing after-hours medication errors in a rural hospital.

BACKGROUND: Hendry Regional Medical Center, a 66-bed facility, has 8.5 hours of pharmacy staffing daily. Review of two years of medication errors indicated that 34% of all medication errors involved selection of the wrong drug from stock after pharmacy hours. PROCESS CHANGES: During 2003 many changes were implemented in the medication management process to enhance medication safety. For example, a limited-access area of the pharmacy was established for night entry by the nursing supervisor. The hospital then implemented services with a newly licensed remote order-entry service. These steps decreased the rate of errors involving wrong drug selection to 15%. Subsequently, a medication error involving selection of the wrong drug at night prompted another look at the process. IMPLEMENTING THE VIDEO VERIFICATION PROCESS: The hospital began using a webcam to create a digital image of the medication selected for removal from the pharmacy stock by the nursing supervisor. This image is transmitted via e-mail. In six months, only one (recent) error resulting from selection of the wrong medication after normal pharmacy hours occurred; the medication selection process simply was not followed. DISCUSSION: Results of medication error reporting indicated that using Webcam/e-mail image transmission and video verification by a pharmacist further improved patient safety in the medication selection process.

After-Hours Care↗
PubMed2001

Merits of duplicate LAN cabling in hospitals.

Our hospital wired three LAN cables separately to improve the data distribution range. One LAN is between the various sections of the hospital (hospital LAN), another is within each section (section LAN), and the other is connected to the Internet (open LAN). The section LAN was connected to the hospital LAN to enable data exchange. Data from the section LAN for common use is collected through the hospital LAN and stored in the central server The duplicate cabling and separate LANs increased the independence of each LAN and the system within each section. The section systems can be changed at anytime without the necessity of reconstructing the whole hospital information system. The data transfer speed of each cable increased. Hospital information processing systems often use a distributed-processing centralized management system. Because of advances in technology, each section can now take responsibility for developing their own system, making the responsibility of the information processing section responsible for hospital information systems more limited than previously. Herein, we show the merits of separate cable installation.

Centralized Hospital Services↗
PubMed2002

Negligible electromagnetic interaction between medical electronic equipment and 2.4 GHz band wireless LAN.

Wireless LANs using radio waves have recently gained popularity for installation in hospitals. Because electromagnetic waves transmitted from mobile telephones have been shown to cause interference with medical electronic equipment, prudence would seem necessary when introducing radio wave communication devices into hospitals. Therefore, we tested the effect of wireless LAN communication on medical electronic equipment and the effect of electronic equipment on wireless LAN communication. We observed nine pieces of electronic equipment in the operating mode while transmitting radio waves from a wireless LAN. Even when the access point was put very close to the medical electronic equipment surface and data was transmitted, no malfunction of the equipment was observed. The medical electronic equipment caused little change in the effectiveness of the communication device, although radio waves emitted from electric knives and a remote patient monitor reduced the reception rate to about 60%. The communication speed of the wireless LAN was temporarily reduced only when a microwave oven was located close to and facing the access point. Because output in Japan is limited to a maximum of 10 mW wireless LAN following the IEEE802.11b standard should be able to be installed safely in Japanese hospitals. However, wireless LAN access points should not be installed near microwave ovens.

Electromagnetic Fields↗
PubMed2002

How to develop a low cost, in-house distance learning center for continuing medical education. Part II.

The first part of this paper discussed the advantages and communication tools needed to create a Distance Learning Center for continuing medical education by using an Intranet or the Internet. This part continues with an explanation of the hardware, software (largely free) and human resources needed for videoconferencing as well as the costs. Suitable even for small hospitals Distance Learning Centers can be of higher quality than traditional methods of continuing medical education.

Costs and Cost Analysis↗
PubMed1994

The Medical Data Index (MDI) dependency module: a shared database to assist discharge planning and audit.

As part of the development of integrated, patient-based hospital information technology (IT) systems in the South-Western Region of England, a module has been developed which will hold core data pertaining to the functional status and current resources of elderly or disabled patients. Its purpose is to assist early identification of unmet needs and facilitate prompt transfer to community care. The module provides a shared database, which is completed or updated as necessary on admission and is then available to all appropriate users of the hospital system, avoiding duplication of data collection. In addition to details of home circumstances and support, it includes brief, standardized assessment scales for activities of daily living and mental state, which will identify the need for specialist referral. A summary is provided for easy communication with other care agencies.

Activities of Daily Living↗
PubMed1989

[Particular aspects of creation and assessment of an obstetrical data bank].

The use of computers improves data storage capacity and leads to a homogeneous documentation of data obtained. After extensive preparations documentation was started using in 1975 the 2nd Department of Obstetrics and Gynecology computer. The obstetrical-gynecological data base is used for organisational, epidemiological, scientific and mixed purposes. The main purpose is periodical evaluation of routine procedures. The evaluation of obstetrical data is often combined with specific problems. To compare the data obtained, clinical findings have to be entered in standardized form and to be related to the week of pregnancy. The expected date of birth has to be corrected often as a result of several investigations. Furthermore, it has to be differentiated between single and multiple pregnancy. Good cooperation between physician and medical computer expert is necessary for good quality of evaluation. The evaluated data enable one to find new aspects and connections, which may offer the impetus to perform new prospective research.

Expert Systems↗