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At least 613 records · Page 34Linked to original sources
PubMed2002

Telerehabilitation research: emerging opportunities.

The field of clinical rehabilitation is rooted in the premise that carefully planned and delivered therapeutic intervention enhances patient outcomes. Underlying this statement is a deeper scientific reality: The field exists because biosystems (e.g., tissues, cells, organs, persons) are inherently adaptive and can dynamically change as a function of a sequence of inputs (e.g., exercise, pharmaceuticals). The tools of telerehabilitation help minimize the barrier of distance, both of patients to rehabilitative services and of researchers to subject populations. This enhanced access opens up new possibilities for discovering and implementing optimized intervention strategies across the continuum of care. Telecommunications technologies are reviewed from the perspective of systems models of the telerehabilitation process, with a focus on human-technology interface design and a special emphasis on emerging home and mobile technologies. Approaches for providing clinical rehabilitation services through telerehabilitation are addressed, including innovative consumer-centered approaches. Finally, telerehabilitation is proposed as a tool for reinvigorating the rehabilitative bioengineering research enterprise.

Computing Methodologies↗
PubMedDate not supplied

Using the Pathfinder system to reduce missed abnormal cervical cytologic smear cases in a rescreening program.

OBJECTIVE: To evaluate the effect of Pathfinder (CompuCyte Corp., Cambridge, Massachusetts, U.S.A.), a process control instrument for microscopes used by cytotechnologists to monitor the mechanical aspects of their screening process, on the false negative cervical cytologic smear rate as detected in daily quality assurance rescreening. STUDY DESIGN: Pathfinder was put into routine use in a large cytology laboratory. After cytotechnologists were trained in its use, they monitored their time spent screening each slide, the area (percent) of the slide screened and the average percentage of overlap of fields of view. The number of abnormal cases missed in screening before and after the introduction of Pathfinder was determined by rescreening a random 10% of the "negative" cases. The evaluation took place over a nine-month period. RESULTS: A decrease in the number of missed abnormal cases was identified. The false negative rate for atypical cells of undetermined significance (ASCUS) fell from 37/2,336 (1.6%) to 12/1,772 (0.7%), for a 56% decrease. The change in the number of squamous intraepithelial lesion cases, even over a nine-month period, was too small for comment. CONCLUSION: The effect of the continuous feedback and process standardization provided by the Pathfinder system was a decrease in the number of abnormal cases missed. This was due primarily to a marked decrease in the number of ASCUS cases missed. The Pathfinder provides a number of innovative management tools to ensure consistent high quality screening.

Cervix Uteri↗
PubMed1995

A teleradiology case conference system.

To investigate the use of teleradiology in the quality assurance programme of a multicentre radiotherapy practice, we installed image acquisition and display workstations at each of two affiliated radiation oncology clinics. A commercial diagnostic teleradiology system was successfully modified to suit the requirements of the radiotherapy subspecialty. The system allowed intersite transmission of images, access to high-resolution images from each site and, by use of laser film scanners, made accessible all types of radiation therapy image. Transmission speed and storage capacity were better than expected. Using the system, radiation oncology residents and staff reviewed 83 complex cases over eight months. Case presentation and discussion were enhanced. In the same period, 276 cases were reviewed by conference in person. Case conferences for quality assurance conducted with the teleradiology system influenced changes in treatment planning as effectively as those conducted in person. Equivalent treatment outcomes were produced. The teleradiology system facilitated quality assurance through review of patients' radiation treatments by allowing natural interactive consultation.

Equipment Design↗
PubMed2004

A perioperative echocardiographic reporting and recording system.

Advances in video capture, compression, and streaming technology, coupled with improvements in central processing unit design and the inclusion of a database engine in the Windows operating system, have simplified the task of implementing a digital echocardiographic recording system. I describe an application that uses these technologies and runs on a notebook computer.

Databases, Factual↗
PubMed1999

On-line computer system to minimize laser injuries during surgery: preliminary system layout and proposal of the key features.

The aim of this paper is to investigate some new user interface ideas and related application packages which aim to improve the degree of safety in an operating room during surgical operations in which an invasive laser beam is deployed. The overall value of the proposition is that a means is provided which ensures the successful completion of the surgical case while minimizing the risk of thermal and mechanical injuries to healthy tissues adjacent to the surgical field. According to surgeons operating with a variety of CO2 lasers available at both the National Cancer Institute in Milan, Italy, and the Sackler School of Medicine, Tel Aviv University, Israel, each laser device presents different cutting and coagulation properties. In order to identify which 'ideal' procedure might corroborate the subjective impression of each surgeon and also to provide one common tool to ensure procedures with a high level of safety, the author has worked for several months with surgeons and technicians of both Institutions to define the general design of a new on-line surgical operation planning and design system to be used during the pre-operative briefing activities and also as a consultation tool during operation. This software package will be developed and tested on both 'C' and FORTRAN compilers running on a commercially available PC which is driving a continuous wave (CW) CO2 laser device via its Instrument Bus interface. The present proposal describes the details of a software package called LCA (Laser-beam Controller and Adviser) which performs several controls in parallel on the key output parameters of a laser beam device during its utilization in delicate surgical operations. The required performances of this device needed during a given surgical operation are pre-simulated and compared against the well-known safety limits, which are stored in the computer's mass storage. If the surgeon's decision about the laser device set-up are considered to be too close to the required physiological safety limits, then the SW alerts the surgeon and proposes alternatives based on other combinations of both HW and SW configurations. An additional application of LCA uses this SW as a warning tool during the operation itself. If a wrong set-up of the laser device is accidentally used, an alarm will be generated and the laser beam automatically switched-off prior to an 'incident report' printout. The operation will continue only when the surgeon validates the choices that the SW suggests for implementation. If necessary, the surgeon can switch off the device and continue to operate it manually. In this case, the surveillance mode will be totally excluded.

Bone Cements↗
PubMed2003

Wireless communications in acute health-care.

Before a particular form of wireless communication is implemented within a health-care institution, consideration should be given to the system's capacity for transmitting voice, data and video information, as well as its reliability and coverage. An important associated choice concerns the best combination of user devices that will enable secure and rapid transmission of data to clinical staff at the point of care. Several technologies are available. No new technology that is likely to become available over the next five years will address the two main concerns of health service organizations: the need for non-interference with sensitive equipment; and the need for immediate communication of urgent messages. We therefore believe that health industries with a mobile workforce will gain five to eight years of useful life from cordless telephone systems and that paging or other radio-based devices will remain an important mode of communication for at least the next five years, especially where emergency communication is concerned.

Hospital Communication Systems↗
PubMed2003

A portable diagnostic workstation based on a Webpad: implementation and evaluation.

A wireless hand-held Webpad device was used to review a sample set of cranial computerized tomography (CT) studies to assess its diagnostic capabilities and its feasibility as a portable diagnostic workstation for radiology. The data-set consisted of 30 head CT studies of emergency cases. Two neuroradiologists and a senior radiologist participated in the evaluation of the portable workstation. They used a Web-based viewer that we developed, which provided all the major functionalities required for radiological image review. The reported radiological findings and diagnoses were compared with a gold standard, comprising a set of diagnoses previously formulated by a consensus panel of radiologists who had reviewed the original studies. The diagnoses made using the Webpad were correct (no major discrepancies) in 82 out of 90 interpretations (91%), which is comparable to the accuracy reported in image review with a conventional radiological workstation. The average total working time per diagnosis was 5 min 25 s (range 2-12 min). The simplicity of use of the system and its low cost make it suitable for distributing radiological studies within hospital facilities.

Adolescent↗
PubMedDate not supplied

Building a highly available and intrusion tolerant Database Security and Protection System (DSPS).

Database Security and Protection System (DSPS) is a security platform for fighting malicious DBMS. The security and performance are critical to DSPS. The authors suggested a key management scheme by combining the server group structure to improve availability and the key distribution structure needed by proactive security. This paper detailed the implementation of proactive security in DSPS. After thorough performance analysis, the authors concluded that the performance difference between the replicated mechanism and proactive mechanism becomes smaller and smaller with increasing number of concurrent connections; and that proactive security is very useful and practical for large, critical applications.

Computer Security↗
PubMed1995

Use of data in a radiology information system for labeling computed radiographs: an interface to connect the two systems.

Computers have greatly facilitated the processing and storage of radiologic information. Manufacturers of radiology information systems (RISs) are gradually incorporating options for interfacing their products with other computers (e.g., hospital information systems). However, a growing need exists to also interface RISs with digital radiologic equipment so that images (e.g., computed radiographs of the chest and skeleton) are automatically labeled with identification data. Such connectivity would eliminate redundant work by technologists, decrease errors in the labeling of images, and increase the consistency of patients' data within a radiology department. Unfortunately, the rapid advances in digital technology, combined with the lack of a well-defined standard for the transfer of demographic information between dissimilar systems, have delayed development of these interfaces. We have developed a widely applicable method to automatically transfer patients' demographic data from an RIS to a commercially available computed radiography system. A personal computer is configured with inexpensive programmable telecommunications software to create an interactive gateway, which eliminates the need for redundant data entry (compared with entering data once on the RIS and again on the stand-alone computed radiography system), and thus also decreases errors in the labeling of images.

Local Area Networks↗
PubMedDate not supplied

Worklists, preloading and archiving strategies; 3 years of clinical experience in the Barcelona PACS.

We present data on 3 years of clinical experience using PACS involving developments on worklists, preloading and archiving strategies in a teaching paediatric hospital with all modalities connected to a commercial PACS. A method allowing generation of and handling of different worklists for computed radiography examinations has been developed in our centre. Worklists and archiving strategies are presented and discussed. We conclude that, with adequate worklists and efficient preloading implementation, current PACS could be used successfully in several clinical settings of a multimodality department.

Algorithms↗
PubMedDate not supplied

A generic methodology for health care data security.

The aim is to outline the framework of a generic methodology for specifying countermeasures in health care environments. The method is specifically aimed at the enhancement of security in existing health care systems, and a key element is the use of predetermined 'profiles' by which these may be classified. Example scenarios are presented to illustrate how the concept could be applied in practice. The paper is based upon work that was initially carried out as part of the Commission of European Communities SEISMED (Secure Environment for Information Systems in MEDicine) project, the aim of which is to provide security recommendations for European health care establishments (HCEs).

Computer Security↗