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At least 613 records · Page 34Linked to original sources

Java-based Open Platform for distributed health telematics applications.

Within the European HARP project, a Java-based Open Platform has been specified and implemented to support trustworthy distributed applications for health. Emphasis was put on security services for enabling both communication and application security. The Open Platform is Web-based and comprises the Client environment, Web/Application server, as well as Database and Archive servers. Servlets composed and executed according to the user's authorisation create signed XML messages. From those messages, user-role-related applets are generated. The technical details of the realisation are presented. Possible future enhancements for user-centric, adaptable services based on next-generation mobile service environments are outlined.

Computer Communication Networks↗

Exploitation of statistical tables: conceptual interaction with epidemiologic data.

Health-care applications need flexible data and interaction models capable of dealing with data of different natures coming from different sources. These applications are usually devoted to diverse user groups, often casual or novice. The user interface must help the user to understand the database information content in his or her querying process. The authors synthetically describe FLN, a system featuring an integrated interaction with epidemiologic data. In an integrated model the statistical aspects of data (macro data) are represented, together with the intensional and extensional views of the variables involved in statistical tables.

Database Management Systems↗

Assessment of patients' acceptance of and satisfaction with teledermatology.

Teledermatology refers to the use of information and communication technologies (such as videoconferencing or transmission of digital images) to enable the practice of diagnostic dermatology between participants separated by geographic distance. The objective of this study was to critically review the quality of evidence about patient satisfaction with teledermatology applications. Sample size, reporting of validity and reliability, used instrument and its underlying constructs were determined for all studies where information was available. Fourteen studies were identified, five refer to store-and-forward applications, the remaining ones describe video-based systems. The systematic review demonstrated that methodological deficiencies in the published research impact the generalizability of findings. The two types of teledermatology (video-based and store-and-forward) require different satisfaction instruments as they are based on different contexts of care delivery, with video-mediated communication being key in the former and patients' absence from the diagnostic process in the latter mode of care delivery.

Dermatology↗

Intelligent visualization and exploration of time-oriented clinical data.

Physicians and other care providers often need to quickly browse and interpret large numbers of time-oriented clinical data. Reducing the information overload involving such tasks is a major goal for medical information systems. We describe a conceptual architecture and software implementation specific to the task of interpretation, summarization, visualization, explanation, and interactive exploration of time-oriented clinical data and the multiple levels of meaningful concepts that can be derived from these data. We build on our work on abstraction of time-oriented clinical data using a knowledge base, acquired from expert physicians, of temporal properties of the data. The core module of the new framework is called KNAVE (Knowledge-based Navigation of Abstractions for Visualization and Explanation). Health care providers can manipulate the display though several visualization and exploration operators. These operators have semantics that are domain independent but that are customized automatically for the application by access to the domain-specific knowledge base. The display, which reflects data and derived interpretations in the patient's database, changes when the user explores key relations (e.g., the dependency hierarchy) in the knowledge base of the relevant clinical domain. Preliminary assessment of the initial prototype with several clinical users has been encouraging. The KNAVE methodology has broad ramifications for reducing the load that large numbers of time-oriented clinical data put on care providers.

Artificial Intelligence↗

An optical scan/statistical package for clinical data management in C-L psychiatry.

This paper explores aspects of the need for clinical database management systems that permit ongoing service management, measurement of the quality and appropriateness of care, databased administration of consultation liaison (C-L) services, teaching/educational observations, and research. It describes an OPTICAL SCAN databased management system that permits flexible form generation, desktop publishing, and linking of observations in multiple files. This enhanced MICRO-CARES software system--Medical Application Platform (MAP)--permits direct transfer of the data to ASCII and SAS format for mainframe manipulation of the clinical information. The director of a C-L service may now develop his or her own forms, incorporate structured instruments, or develop "branch chains" of essential data to add to the core data set without the effort and expense to reprint forms or consult with commercial vendors.

Computer Systems↗

HOLON: extending Web document libraries via objects in order to support the health information infrastructure. Health Object Library Online.

In HOLON, user clients, applications, data servers, and fine-grained elements are all objects in a document library. To that end, this paper reviews the past year of progress and lessons learned in HOLON for integrating the Web, HL7, CORBA, Arden, KQML, UMLS Thesaurus, and other standards to determine if object technology reduces common problems in document-centric libraries such as indexing, searching/retrieving, complex data type management, and maintenance, among others.

Computer Systems↗

Foundations of a healthcare knowledge management application system.

Much of the knowledge management (KM) literature suggests that organizations should adopt either a "personalization" or "codification" strategy and that to mix the two is unwise. Two European schools have come to the conclusion that a broad strategy is needed. Its key conceptual elements are in three dimensions: the type (explicit - tacit), focus (information - learning) and organization (digital - social) of knowledge. Without this broad approach it is impossible to reconcile the wish to provide (codified) evidence-based solutions to populations at the same time as personalized care for individuals.

Hospital Information Systems↗

Final results and exploitation plans for MammoGrid.

The MammoGrid project has delivered the first deployed instance of a healthgrid for clinical mammography that spans national boundaries. During the last year, the final MammoGrid prototype has undergone a series of rigorous tests undertaken by radiologists in the UK and Italy and this paper draws conclusions from those tests for the benefit of the Healthgrid community. In addition, lessons learned during the lifetime of the project are detailed and recommendations drawn for future health applications using grids. Following the completion of the project, plans have been put in place for the commercialisation of the MammoGrid system and this is also reported in this article. Particular emphasis is placed on the issues surrounding the transition from collaborative research project to a marketable product. This paper concludes by highlighting some of the potential areas of future development and research.

Breast Neoplasms↗

Using the Web to aid biochemists and microbiologists: an example of computer-based learning using PCR as an example.

The aim of this study was two-fold: to make available to the medical community a fast, efficient tool for troubleshooting PCR problems, and to demonstrate that hypermedia allow one to approach this kind of problem in a new, more useful way. The Web provides access to an enormous amount of information in the medical area, and in particular enables troubleshooting of new techniques in the medical laboratory. Currently it is possible to find textual information but it is not always easy to find hypermedia information. In many cases authors change only the means of dissemination of a book or paper to the Web, but do not adapt the information to the features of this new medium. The prototype of our hypermedia application was developed using Director and Flash programs (Macromedia), the application was developed from a decision tree built as a result of information compiled from expert PCR users and the existing literature. It was implemented on a website using Dreamweaver (Macromedia). The usefulness and possibilities of this application have been tested with physicians, medical laboratory technicians, and health science students, and have been proven to be more effective than traditional methods, both in education processes and in helping researchers and medical laboratory technicians in their daily work. The advance and popularization of the Internet in the medical profession requires information on the Web to adapt to the advantages offered by hypermedia. This new step must be taken, and the Web must offer medical users not only a different medium of information distribution but also a new way of handling and obtaining information.

Biochemistry↗

Using stereoscopy for medical virtual reality.

The use of stereoscopy to enhance the immersive experience obtained from a virtual environment is well known, and many medical applications can benefit from this technology. The stereoscopic projection sessions at the last two MMVR conferences contain many excellent examples. Stereoscopy need not be expensive to implement, and can easily be provided on a desktop PC. This paper looks at the different options available today, from active stereo, to passive stereo, to autostereoscopic displays, and their deployment on both high-end and low-end systems. The potential benefits of these different approaches are illustrated with examples from medical visualisation projects currently being carried out at the Manchester Visualization Centre (MVC).

Depth Perception↗

[Statistical use of a database (Bull-SOPRA-ADICAP system). Application in the study of cancers in women].

The author analyses the frequency of cancer among women for 2 years at pathological department of Bichat's hospital. He presents a method about how to use the computer système Bull-SOPRA of "Assistance Publique de Paris". Among 13,778 women, he counts 750 primary invasive malignant tumors which 3/4 are grouped among fifties to eighties. The author notes cancers frequency doubles nearly every 10 years and notes an often late appearance of breast cancers which are known to reach women between 60 to 90.

Adolescent↗

New concepts and technologies in home care and ambulatory monitoring.

The world is becoming more and more health conscious. Society, health policy and patients' needs are all changing dramatically. The challenges society is currently facing are related to the increase in the aging population, changes in lifestyle, the need for healthcare cost containment and the need for improvement and monitoring of healthcare quality. The emphasis is put on prevention rather than on treatment. In addition, patients and health consumers are waiting for non-invasive or minimally-invasive diagnosis and treatment methods, for home care, short stays in hospital, enhancement of rehabilitation, information and involvement in their own treatment. Progress in science and technology offers, today, miniaturization, speed, intelligence, sophistication and new materials at lower cost. In this new landscape, microtechnologies, information technologies and telecommunications are key factors. Telemedicine has also evolved. Used initially to exchange patients' files, radiographic data and other information between health providers, today telemedicine contributes to new trends in "hospital extension" through all-day monitoring of vital signs, professional activities, entertainment and home-based activities. The new possibilities for home care and ambulatory monitoring are provided at 4 levels: a) Microsensors. Microtechnologies offer the possibility of small size, but also of intelligent, active devices, working with low energy, wireless and non-invasive or minimally-invasive; b) Wrist devices are particularly user friendly and combine sensors, circuits, supply, display and wireless transmission in a single box, very convenient for common physical activities; c) Health smart clothes make contact with 90 % of the skin and offer many possibilities for the location of sensors. These sensors have to be thin, flexible and compatible with textiles, or made using textile technologies, such as new fibers with specific (mechanical, electrical and optical) properties; d) Health smart homes. The aim of this method is to improve the patient's living conditions and to avoid the cost of long hospitalization. "Exosensors" are used for measurement of the activity and behavior of the patient. The field of applications is very large, e.g. continuous monitoring of elderly populations, professional and military activities, athletes performance and condition, and people with disabilities. This new healthcare approach has to take into account lifestyle for improving prevention. For the patient to be more and more involved in his/her own therapy, new responsibilities and ethics have to be defined. A "societal health education" has to be provided to physicians and to patients to get all the benefits of this new context.

Biomedical Technology↗

Application of fuzzy functions for visual presentation of medical data.

While interpretation of medical data is very often an ambiguous process, computers usually display results of recommendations, provided by both human experts and computer algorithms, as concrete data. This study proposes a visual presentation of relative degrees of uncertainty along with "standard" concrete medical data. A medical parameter (mean arterial pressure) is dynamically evaluated during surgery for being too low or too high. Fuzzy membership functions are utilized to display degrees of deviation in the form of a clear and concise pie chart. Thus, in the Operating Room the anesthesiologist can be provided with an easy statistical assessment of uncertainty of existing recommendations.

Algorithms↗

The use of knowledge-based systems in medicine in developing countries: a luxury or a necessity?

Knowledge-based systems (KBSs) in medicine have received much attention over the past two decades, mainly because of the potential benefits that can be gained from using them. They may facilitate in increasing productivity in a medical environment, support the making of diagnoses and other types of medical decisions, assist in the training of medical professionals, and can even handle some routine tasks in a medical environment. However, some critical problems in this field have also been identified. For example, research indicated that some problems can be solved partially, but not completely, with existing artificial intelligence techniques. Another problem is that many of the existing medical information systems do not support the integration of KBSs in a natural way. Furthermore, the routine use of a medical KBS is complicated by legal issues. These and other problems contribute to what we experience today: a large proportion of the medical KB applications that are developed is never actually used in practice. This justifies questions such as: Should developing countries, having limited infrastructure and research resources, invest in medical KBSs research and development, or should this field be regarded as a luxury that only belongs to developed countries?, and: Can developing countries really benefit from the use of these systems? These questions are discussed in this paper. We highlight the main problems surrounding the development and use of medical KBSs. With the focus on developing countries we discuss potential benefits that could be obtained by investing in these systems and we offer guidelines for focusing research and development of medical KBSs.

Artificial Intelligence↗

Telematics in the northern United Kingdom.

The application, integration and development of methods and technology facilitating the seamless interchange of clinical, demographic and administrative information presented the medical and clinical community with unforeseen problems. Surprisingly, the wealth of existing solutions did not find the expected application and acceptance in hospital/General Practice environments. Even more surprising was the fact of the failure of many computer-based solutions to deliver the expected benefits. This paper outlines the Telematics project established in the Northern United Kingdom and its success in maintaining a working balance between technological needs and the clinical requirements. The result is a robust service linking five major Trusts and 12 General Practices in terms of clinical and administrative data, e-mail and other facilities.

Computer Communication Networks↗

3LGM2-modeling to support management of health information systems.

OBJECTIVE: Both regional health information systems (rHIS) and hospital information systems (HIS) need systematic information management. Due to their complexity information management needs a thorough description or model of the managed information system. METHODS: The three layer graph-based meta-model (3LGM(2)) and the 3LGM(2) tool provide means for effectively describing and modeling HIS by hospital functions, application systems and physical data processing components. The 3LGM(2) tool has been used to model parts of the information system of the health care system of the German federal state Saxony and of the Leipzig University Medical Centre. RESULTS: Experiences showed, that 3LGM(2) is suitable for supporting information management even in rHIS. We explain some benefits for information management in regional as well as local settings. CONCLUSIONS: Acceptance of the 3LGM(2) depends strictly on its integration in management structures on the institutional, regional, and even national or European level.

Germany↗

Federating distributed and heterogeneous information sources in neuroimaging: the NeuroBase Project.

The NeuroBase project aims at studying the requirements for federating, through the Internet, information sources in neuroimaging. These sources are distributed in different experimental sites, hospitals or research centers in cognitive neurosciences, and contain heterogeneous data and image processing programs. More precisely, this project consists in creating of a shared ontology, suitable for supporting various neuroimaging applications, and a computer architecture for accessing and sharing relevant distributed information. We briefly describe the semantic model and report in more details the architecture we chose, based on a media-tor/wrapper approach. To give a flavor of the future deployment of our architecture, we de-scribe a demonstrator that implements the comparison of distributed image processing tools applied to distributed neuroimaging data.

Databases as Topic↗

EvoCare: a new standard in tele-therapy.

The necessity for Integrated Care has been debated controversially and the influence of the legislator and the consequences for the medical device industry discussed sufficiently. In fact, the German health system has been suffering from a lot of problems like cost expansions, but only solutions and not discussions can bring a progress. EvoCare has established a new standard in tele-therapy in Germany. This has been possible because this system maps the clinical therapy process to tele-therapy (and not vice versa), it is extendable for virtually any medical field of application, and the user interface is kept so simple that people inexperienced with computers and even with motor deficits are able to use it. Accompanying the patients from the hospital to their homes, EvoCare allows for shorter hospital stays without loss in treatment quality and more intense training without increasing therapists' average work time per patient. The experiences that have already been made with the described system, especially in the area of neurological rehabilitation and orthopedic prevention, underline its advantages for all involved partners.

Comprehensive Health Care↗